Depression has enormous societal burdens, with annual U.S. economic costs of tens of billions of dollars due largely to productivity losses. Comparative cost-of-illness studies show that depression is among the most costly of all health problems to employers.

Philip S. Wang, M.D., Dr.P.H., of the National Institute of Mental Health, Rockville, Md., and colleagues examined the impact of a depression outreach-treatment program on the outcomes of depression symptom relief, job retention, sickness absence, and increased work productivity.

The randomized controlled trial included 604 employees who were identified as having significant depression. The telephonic outreach and care management program encouraged workers (n = 304) to enter outpatient treatment (psychotherapy and/or antidepressant medication), monitored treatment quality continuity, and attempted to improve treatment by giving recommendations to clinicians. Participants reluctant to enter treatment were offered a structured telephone cognitive behavioural psychotherapy. Three hundred participants received usual care.

The researchers found that measurements of depression severity were significantly lower in the intervention than in the usual care group by 12 months, and that patients in the intervention group were more likely to experience recovery (26.2 percent versus 17.7 percent). Scores on the hours worked measure were significantly higher in the intervention than usual care group at 12 months.

The data indicated that workers in the intervention group worked an average of two more hours per week than workers in the usual care group, which is equivalent to an annualized effect of more than two weeks of work. This overall effect was due to a higher rate of job retention (92.6 percent versus 88.0 percent) and significantly more hours worked among employed respondents.; Source: JAMA and Archives Journals