Hostname: page-component-7c8c6479df-7qhmt Total loading time: 0 Render date: 2024-03-28T18:42:12.773Z Has data issue: false hasContentIssue false

Adjuvant occupational therapy for work-related major depression works: randomized trial including economic evaluation

Published online by Cambridge University Press:  20 November 2006

AART H. SCHENE
Affiliation:
Department of Psychiatry, Programme for Mood Disorders, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
MAARTEN W. J. KOETER
Affiliation:
Department of Psychiatry, Programme for Mood Disorders, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
MARTIJN J. KIKKERT
Affiliation:
Department of Psychiatry, Programme for Mood Disorders, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
JAN A. SWINKELS
Affiliation:
Department of Psychiatry, Programme for Mood Disorders, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
PAUL McCRONE
Affiliation:
Health Services Department, Institute of Psychiatry, London, UK

Abstract

Background. Major depression has far-reaching consequences for work functioning and absenteeism. In most cases depression is treated by medication and clinical management. The addition of occupational therapy (OT) might improve outcome. We determined the cost-effectiveness of the addition of OT to treatment as usual (TAU).

Method. Sixty-two adults with major depression and a mean absenteeism of 242 days were randomized to TAU (out-patient psychiatric treatment) or TAU+OT [6 months, including (i) diagnostic phase with occupational history and work reintegration plan, and (ii) therapeutic phase with individual sessions and group sessions]. Main outcome domains were depression, work resumption, work stress and costs. Assessments were at baseline and at 3, 6, 12 and 42 months.

Results. The addition of OT to TAU: (i) did not improve depression outcome, (ii) resulted in a reduction in work-loss days during the first 18 months, (iii) did not increase work stress, and (iv) had a 75·5% probability of being more cost-effective than TAU alone.

Conclusion. Addition of OT to good clinical practice does not improve depression outcome, improves productivity without increasing work stress and is superior to TAU in terms of cost-effectiveness.

Type
Research Article
Copyright
2006 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)