Improving work outcomes of dysthymia (persistent depressive disorder) in an employed population

ObjectiveTo test the effectiveness of a work-focused intervention (WFI) on the work outcomes of employed adults with dysthymia.MethodThis 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).ResultsWork 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).ConclusionAt 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.