Course of Depressive Symptoms Following a Workplace Injury: A 12-Month Follow-Up Update

• Published in: Journal of occupational rehabilitation Vol. 26; no. 2; pp. 204 - 215
• Main Authors: Carnide, Nancy, Franche, Renée-Louise, Hogg-Johnson, Sheilah, Côté, Pierre, Breslin, F. Curtis, Severin, Colette N., Bültmann, Ute, Krause, Niklas
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2016; Springer; Springer Nature B.V
• Subjects: Accidents, Occupational - psychology; Accidents, Occupational - statistics & numerical data; Adult; Canada - epidemiology; Care and treatment; Clinical Psychology; Cohort analysis; Consent; Depression - diagnosis; Depression - epidemiology; Depression - psychology; Depression, Mental; Depressive Disorder - diagnosis; Depressive Disorder - epidemiology; Depressive Disorder - psychology; Depressive Disorder - rehabilitation; Diagnosis; Environmental Health; Female; Follow-Up Studies; Health Psychology; Health sciences; Humans; Incidence; Injuries; Interviews; Male; Medical diagnosis; Medicine; Medicine & Public Health; Mental depression; Mental health; Middle Aged; Musculoskeletal Diseases - diagnosis; Musculoskeletal Diseases - psychology; Occupational accidents; Occupational health; Occupational Injuries - epidemiology; Occupational Injuries - psychology; Occupational Medicine/Industrial Medicine; Orthopedics; Participation; Prevalence; Prospective Studies; Public health; Rehabilitation; Return to Work; Self report; Sick leave; Sociodemographics; Statistical analysis; Work-related injuries; Workers compensation; Workers' Compensation - statistics & numerical data; Workplace; Canada; Occupational injuries; Depression; Workers’ compensation
• ISSN: 1053-0487; 1573-3688
• DOI: 10.1007/s10926-015-9604-3

Introduction To estimate the prevalence, incidence and course of depressive symptoms, their relationship with return-to-work, and prevalence of depression diagnosis/treatment 12 months following a lost-time workplace musculoskeletal injury. Methods In a prospective cohort study, 332 workers’ compensation claimants with a back or upper extremity musculoskeletal disorder completed interviews at 1, 6 and 12 months post-injury. Participants self-reported they had not received a depression diagnosis 1 year pre-injury. Cutoff of 16 on the CES-D defined a high level of depressive symptoms. Self-reported data on depression diagnosis and treatment and work status since injury were collected. Results Cumulative incidence of high depressive symptom levels over 12 months was 50.3 % (95 % CI 44.9–55.7 %). At 12 months, 24.7 % (95 % CI 20.1–29.3 %) of workers exhibited high levels. Over 12 months, 49.7 % (95 % CI 44.3–55.1 %) had low levels at all 3 interviews, 14.5 % (95 % CI 10.7–18.2 %) had persistently high levels, and 25.6 % (95 % CI 20.9–30.3 %) demonstrated improvements. Among workers with low baseline levels, incidence of high levels at 12 months was 6.0 % (95 % CI 2.7–9.3 %). For workers with high baseline levels, 36.1 % (95 % CI 27.9–44.3 %) exhibited persistent high symptoms at 6 and 12 months, while 38.4 % (95 % CI 30.1–46.6 %) experienced low levels at 6 and 12 months. Problematic RTW outcomes were common among workers with a poor depressive symptom course. Among workers with persistent high symptoms, 18.8 % (95 % CI 7.7–29.8 %) self-reported receiving a depression diagnosis by 12 months and 29.2 % (95 % CI 16.3–42.0 %) were receiving treatment at 12 months. Conclusions Depressive symptoms are common in the first year following a lost-time musculoskeletal injury and a poor depressive symptom course is associated with problematic RTW outcomes 12 months post-injury. While symptoms appear to improve over time, the first 6 months appear to be important in establishing future symptom levels and may represent a window of opportunity for early screening.