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

Authors: Schneider, J., Slade, J., Secker, J., Rinaldi, M., Boyce, M., Johnson, R., ... & Grove, B.
Year Published 2007
Publication Psychological Medicine
Volume 37
Number 3
Pages 351-362
Publisher Cambridge Press

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.


The purpose of the study was to determine the cost-effectiveness of the addition of OT to treatment as usual (TAU).


Study was conducted as part of the Programme for Mood Disorders of the Department of Psychiatry on the Academic Medical Centre in Amsterdam.


The study sample included 62 adults. The inclusion criteria were: age above 18 years, major depressive disorder, single episode or recurrent, without psychotic features, no history of psychos, manic, hypo-manic or cyclothymic features, no history of alcohol abuse or dependence, and additional criteria.

Data Collection

Treatment effect of OT was tested using the t test for continuous measures and the chi-squared test for categorical variables. For longitudinal analysis, the generalized estimating equations method for dichotomous outcomes and a generalized linear model approach for continuous outcomes was used.


Treatment as usual was the standard outpatient treatment for depression. This consisted of clinical management and antidepressants, if indicated and accepted by patients, according to standard treatment algorithm.


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.


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

Disabilities Emotional disturbance
Populations Male & Female
Outcomes Other
Research Design Randomized Controlled Trials (RCTs)
Peer Reviewed Yes