Yu-Chen Chiang1, Tsan-Hon Liou2,3, Hsin-Chien Lee4,5, Reuben Escorpizo6,7. 1. Department of Psychiatry, Taipei Medical University Shuang Ho Hospital, Taipei 23561, Taiwan. 2. Department of Physical Medicine and Rehabilitation, Taipei Medical University Shuang Ho Hospital, Taipei 23561, Taiwan. 3. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan. 4. Department of Psychiatry, Taipei Medical University Hospital, Taipei 11031, Taiwan. 5. Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei 11031, Taiwan. 6. Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT 05452, USA. 7. Participation, Integration & Social Epidemiology Group, Swiss Paraplegic Research, 6207 Nottwil, Switzerland.
Abstract
Background: Major depressive disorder (MDD) is a highly prevalent mental disorder which causes public health burden and personal disabilities. In people with mental illness, unemployment is an index character of functional impairment. Methods: Using the Taiwan Databank of Persons with Disability (TDPD), we collected the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) scores for people with MDD-associated disability. We recorded and analyzed the scores of participants during a 3-year period to determine the impact of employment on the trajectory of functional change. Logistic regression was performed to analyze the association between employment and changes in WHODAS 2.0 scores. Results: In people with MDD-associated disability, unemployed individuals present a worse function initially compared to employed individuals. After a 3-year period, the employed group showed a significant functional improvement in the domains of cognition, mobility, and participation. In logistic regression, the odds of having functional improvement were twice as high for those who were employed compared with those who were not. Conclusions: Higher odds of having functional improvement were noted in participants who stay in employment. Programs and strategies to help people with MDD-associated disability resume work warrant more clinical attention and supportive policies from the government.
Background: Major depressive disorder (MDD) is a highly prevalent mental disorder which causes public health burden and personal disabilities. In people with mental illness, unemployment is an index character of functional impairment. Methods: Using the Taiwan Databank of Persons with Disability (TDPD), we collected the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) scores for people with MDD-associated disability. We recorded and analyzed the scores of participants during a 3-year period to determine the impact of employment on the trajectory of functional change. Logistic regression was performed to analyze the association between employment and changes in WHODAS 2.0 scores. Results: In people with MDD-associated disability, unemployed individuals present a worse function initially compared to employed individuals. After a 3-year period, the employed group showed a significant functional improvement in the domains of cognition, mobility, and participation. In logistic regression, the odds of having functional improvement were twice as high for those who were employed compared with those who were not. Conclusions: Higher odds of having functional improvement were noted in participants who stay in employment. Programs and strategies to help people with MDD-associated disability resume work warrant more clinical attention and supportive policies from the government.
Entities:
Keywords:
WHODAS 2.0; employment; functional impairment; major depressive disorder
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