A 5-year prospective study of predictors for functional and work disability among primary care patients with depressive disorders

• Published in: European psychiatry Vol. 30; no. 1; pp. 51 - 57
• Main Authors: Riihimäki, K, Vuorilehto, M, Isometsä, E
• Format: Journal Article
• Language: English
• Published: England Elsevier Masson SAS 01.01.2015
• Subjects: Adult; Comorbidity; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Depressive disorders; Disability; Disabled Persons; Employment; Female; Follow-Up Studies; Humans; Internal Medicine; Major depression; Male; Middle Aged; Pensions; Prevalence; Primary care; Primary Health Care - statistics & numerical data; Prospective Studies; Psychiatry; Retirement; Sick Leave; Time Factors; Work disability; Disability; Major depression; Primary care; Depressive disorders; Work disability
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2014.02.005

Abstract Objective To study prevalence of and predictors for functional and work disability among primary care (PC) patients with depressive disorders in prospective long-term follow-up. Methods The Vantaa Primary Care Depression Study followed up prospectively 137 patients with depressive disorders for 5 years with a life chart. Information on level of functioning in general and in different dimensions, employment, sick leaves and disability pensions were obtained from interviews and patient records. Results Level of functioning and work ability were strongly associated with time spent depressed and/or current severity of depression. Patients who belonged to the labour force at baseline spent one-third of the follow-up off work due to depression; two-thirds were granted sick leaves, and one-tenth a disability pension due to depression. Longer duration of depression, co-morbid disorders and having received social assistance predicted dropping out from work. Conclusion Duration of depressive episodes appears decisive for long-term disability among PC patients with depression. Patients spent one-third of the follow-up off work due to depression, and remaining outside the labour force is a common outcome. Psychiatric and somatic co-morbidities, education and socio-economic means influence the level of functioning and ability to work, but are not equally important for all areas of life.