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. |
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Year Published | 2007 |
Publication | Psychological Medicine |
Volume | 37 |
Number | 3 |
Pages | 351-362 |
Publisher | Cambridge Press |
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. |
Purpose |
The purpose of the study was to determine the cost-effectiveness of the addition of OT to treatment as usual (TAU). |
Setting |
Study was conducted as part of the Programme for Mood Disorders of the Department of Psychiatry on the Academic Medical Centre in Amsterdam. |
Sample |
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. |
Control |
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. |
Findings |
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. |
Conclusions |
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 |
URL | http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?LinkFrom=OAI&ID=22007000440 |
Disabilities | Emotional disturbance |
Populations | Male & Female |
Outcomes | Other |
NIDILRR Funded | No |
Research Design | Randomized Controlled Trials (RCTs) |
Peer Reviewed | Yes |