Antidepressant drug effects on return to work; depression, anxiety and stress-related mental illness. A three months follow-up.

Problem

Are patients on sick leave due to depression, anxiety and stress-related mental illness and that are treated with antidepressant drugs during any part of the period more prone to return later to work compared with patients treated with psychological or other therapy? Do the two groups have the same group characteristics?

Approach

According to a Swedish registry study from 2012 it is suggested that pharmacological treatment of depression, anxiety and stress-related disorders results in a longer sick leave and a higher frequency of not-time-limited sick leaves than other forms of treatment. The study need to be verified concerning various diagnostic groups, the severity of dysfunction and possible comorbidities.

This ongoing prospective observational study is scheduled for 180 individuals who were on sick leave because of anxiety and depression, including stress-related disorders in the region of Västra Götaland , Sweden, during 2014-2015. After consent each subject responded a bank of questions to ensure the diagnosis, symptom depth, severity, sick leave and any comorbidity and ongoing medication and / or treatment. Data acquisition has been repeated after 3, 6 and 12 months. This work concerns the time until three months after enrollment.

Unlike most other regions in Sweden, there are enough resources of psychological therapy in the region of Västra Götaland , leading to the result that treatment with psychological treatment is a real alternative to drug therapy. Therefore, it is likely that both psychological and pharmacological therapies are largely distributed according to current guidelines in collaboration between the patient and the clinician. The study will therefore have an ample opportunity to answer the question of whether patients on sick leave due to depression, anxiety and stress-related mental illness and who, during any part of the period of illness, are treated with antidepressant drugs, will return later to work. They are compared with patients treated with psychological therapy (cognitive behavioral therapy and other psychological treatments) or other therapy. The study will also make it possible to assess whether the groups characteristic differs. Our hypothesis is that a difference in sick leave might be seen already after three months.

Findings

Data collection is ongoing. The results will be presented in July.

Consequences

The result could have practical implications for the design of future guidelines for the treatment of depression and anxiety disorders.