David A Adler1, Debra Lerner2, Zachary L Visco3, Annabel Greenhill4, Hong Chang5, Elina Cymerman6, Francisca Azocar7, William H Rogers8. 1. Program on Health, Work, and Productivity, Tufts Medical Center, 800 Washington Street, #345, Boston, MA 02111, USA; Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA 02111, USA; Department of Psychiatry, Tufts Medical Center, 800 Washington Street, #345, Boston, MA 02111, USA. Electronic address: dadler@tuftsmedicalcenter.org. 2. Program on Health, Work, and Productivity, Tufts Medical Center, 800 Washington Street, #345, Boston, MA 02111, USA; Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA 02111, USA; Department of Psychiatry, Tufts Medical Center, 800 Washington Street, #345, Boston, MA 02111, USA. Electronic address: dlerner@tuftsmedicalcenter.org. 3. Program on Health, Work, and Productivity, Tufts Medical Center, 800 Washington Street, #345, Boston, MA 02111, USA. Electronic address: zvisco@tuftsmedicalcenter.org. 4. Program on Health, Work, and Productivity, Tufts Medical Center, 800 Washington Street, #345, Boston, MA 02111, USA. Electronic address: agreenhill@tuftsmedicalcenter.org. 5. Program on Health, Work, and Productivity, Tufts Medical Center, 800 Washington Street, #345, Boston, MA 02111, USA. Electronic address: hchang@tuftsmedicalcenter.org. 6. Department of Psychiatry, Tufts Medical Center, 800 Washington Street, #345, Boston, MA 02111, USA. Electronic address: ecymerman@tuftsmedicalcenter.org. 7. OptumHealth, 425 Market Street, 14th Floor San Francisco, CA 94105, USA. Electronic address: francisca.azocar@optum.com. 8. Program on Health, Work, and Productivity, Tufts Medical Center, 800 Washington Street, #345, Boston, MA 02111, USA. Electronic address: whrogers@tuftsmedicalcenter.org.
Abstract
OBJECTIVE: To test the effectiveness of a work-focused intervention (WFI) on the work outcomes of employed adults with dysthymia. METHOD: This subgroup analysis from a randomized controlled trial compares an initial sample of 167 employees (age: ≥45 years), screened for dysthymia using the PC-SAD without current major depressive disorder randomized to WFI (n=85) or usual care (UC) (n=82). Study sites included 19 employers and five additional organizations. Telephone-based WFI counseling (eight, twice monthly 50-min sessions) provided work coaching and modification, care coordination and cognitive behavioral therapy. Adjusted mixed effects models compared the WFI vs. UC group preintervention to 4-month postintervention change in at-work limitations measured by the Work Limitations Questionnaire. Secondary outcome analysis compared the change in self-reported absences and depression symptom severity (Patient Health Questionnaire PHQ-9 scores). RESULTS:Work productivity loss scores improved 43.0% in the WFI group vs. 4.8% in UC (difference in change: P<.001). Absence days declined by 58.3% in WFI vs. 0.0% in UC (difference in change: P=.09). Mean PHQ-9 depression symptom severity declined 44.2% in WFI vs. 5.3% in UC (difference in change: P<.001). CONCLUSION: At 4 months, the WFI was more effective than UC on two of the three outcomes. It could be an important mental and functional health improvement resource for the employed dysthymic population.
RCT Entities:
OBJECTIVE: To test the effectiveness of a work-focused intervention (WFI) on the work outcomes of employed adults with dysthymia. METHOD: This subgroup analysis from a randomized controlled trial compares an initial sample of 167 employees (age: ≥45 years), screened for dysthymia using the PC-SAD without current major depressive disorder randomized to WFI (n=85) or usual care (UC) (n=82). Study sites included 19 employers and five additional organizations. Telephone-based WFI counseling (eight, twice monthly 50-min sessions) provided work coaching and modification, care coordination and cognitive behavioral therapy. Adjusted mixed effects models compared the WFI vs. UC group preintervention to 4-month postintervention change in at-work limitations measured by the Work Limitations Questionnaire. Secondary outcome analysis compared the change in self-reported absences and depression symptom severity (Patient Health Questionnaire PHQ-9 scores). RESULTS: Work productivity loss scores improved 43.0% in the WFI group vs. 4.8% in UC (difference in change: P<.001). Absence days declined by 58.3% in WFI vs. 0.0% in UC (difference in change: P=.09). Mean PHQ-9 depression symptom severity declined 44.2% in WFI vs. 5.3% in UC (difference in change: P<.001). CONCLUSION: At 4 months, the WFI was more effective than UC on two of the three outcomes. It could be an important mental and functional health improvement resource for the employed dysthymic population.
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