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Gains in employment status following antidepressant medication or cognitive therapy for depression

  • Jay C. Fournier (a1), Robert J. DeRubeis (a2), Jay Amsterdam (a3), Richard C. Shelton (a4) and Steven D. Hollon (a5)...

Abstract

Background

Depression can adversely affect employment status.

Aims

To examine whether there is a relative advantage of cognitive therapy or antidepressant medication in improving employment status following treatment, using data from a previously reported trial.

Method

Random assignment to cognitive therapy (n = 48) or the selective serotonin reuptake inhibitor paroxetine (n = 93) for 4 months; treatment responders were followed for up to 24 months. Differential effects of treatment on employment status were examined.

Results

At the end of 28 months, cognitive therapy led to higher rates of full-time employment (88.9%) than did antidepressant medication among treatment responders (70.8%), χ2 1 = 5.78, P = 0.02, odds ratio (OR) = 5.66, 95% CI 1.16–27.69. In the shorter-term, the main effect of treatment on employment status was not significant following acute treatment (χ2 1 = 1.74, P = 0.19, OR = 1.77, 95% CI 0.75–4.17); however, we observed a site×treatment interaction (χ2 1 = 6.87, P = 0.009) whereby cognitive therapy led to a higher rate of full-time employment at one site but not at the other.

Conclusions

Cognitive therapy may produce greater improvements in employment v. medication, particularly over the longer term.

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Copyright

Corresponding author

Jay C. Fournier, PhD, Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. Email: fournierjc@upmc.edu

Footnotes

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This research was supported by grants MH55877 (R10 PI to R.J.D.) and MH55875 (R10 PI to S.D.H.) from the National Institute of Mental Health, Bethesda, MD. J.A. receives grant support from NIMH grants MH06099, MH060353, MH080097, MH077580, and NIH/NCCAM grant AT005074. J.C.F. receives grant support from NIMH grant MH097889. GlaxoSmithKline provided medications and pill-placebos for the trial.

Declaration of interest

R.C.S. has served as a consultant for Bristol-Myers Squibb, Cerecor, Cyberonics, Eli Lilly, Forest Pharmaceuticals, Janssen Pharmaceutica, Medtronic, Naurex, Pamlab, Pfizer, Ridge Diagnostics, Shire and Takeda Pharmaceuticals. He has received research and/or grant support from Assurex, Cerecor, Elan Corp, Euthymics Bioscience, Forest Pharmaceuticals, Janssen Pharmaceutica, Jazz Pharmaceuticals, Naurex, Novartis Pharmaceuticals, Otsuka America, Pamlab, Pfizer, Repligen Corp, Ridge Diagnostics, St Jude Medical, and Takeda Pharmaceuticals.

Footnotes

References

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Gains in employment status following antidepressant medication or cognitive therapy for depression

  • Jay C. Fournier (a1), Robert J. DeRubeis (a2), Jay Amsterdam (a3), Richard C. Shelton (a4) and Steven D. Hollon (a5)...
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