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Opinion paper: poor response to treatment of depression in people in high occupational levels

Published online by Cambridge University Press:  12 October 2018

Laura Mandelli ,
Alessandro Serretti ,
Stefano Porcelli ,
Daniel Souery ,
Julien Mendlewicz ,
Siegfried Kasper ,
Stuart Montgomery  and
Joseph Zohar
Laura Mandelli
Affiliation:
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
Alessandro Serretti*
Affiliation:
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
Stefano Porcelli
Affiliation:
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
Daniel Souery
Affiliation:
Laboratoire de Psychologie Médicale, Université Libre de Bruxelles and PsyPluriel, Brussels, Belgium
Julien Mendlewicz
Affiliation:
Université Libre de Bruxelles, Brussels, Belgium
Siegfried Kasper
Affiliation:
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
Stuart Montgomery
Affiliation:
Imperial College, University of London, London, UK
Joseph Zohar
Affiliation:
Expert Platform on Mental Health, Focus on Depression Tel-Aviv University Israel, Tel-Aviv, Israel
*
Author for correspondence: Alessandro Serretti, E-mail: alessandro.serretti@unibo.it
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Abstract

The working environment may have a significant effect on response to treatment of depression and this issue has not yet been sufficiently addressed in the scientific literature. There is evidence showing that being engaged in high-level positions can be an obstacle to the success of treatment. This article discusses the few evidence in the literature and some of the possible mechanisms involved. Specific personality attributes and difficulties in adapting to depression may delay access to care and may also reduce treatment compliance. The presence of stress in jobs that require high cognitive function and lack of social support may be elements that hinder the recovery process. Residual symptoms that impact on cognitive functions may undermine adherence to treatment and adversely affect the response. The implications of these issues are potentially relevant for clinical practice in the treatment of depression and for future research.

Keywords

Depressionoccupationoccupational leveltreatmentwork
Type
Commentary
Information
Psychological Medicine , Volume 49 , Issue 1 , January 2019 , pp. 49 - 54
Copyright
Copyright © Cambridge University Press 2018 

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