Depression is the greatest contributor to worldwide disability. The purpose of this study was to understand the influence of antidepressant and psychotherapy treatment adherence on future work leaves for patients with major depressive disorder. Patients with a newly diagnosed major depressive disorder (n = 26,256) were identified in IBM® Watson™ MarketScan® medical and disability claims databases. Antidepressant and psychotherapy adherence metrics were evaluated in the acute phase of treatment, defined as the 114 days following the depression diagnosis. Multiple variable Cox proportional hazards regression models evaluated the influence of antidepressant and/or psychotherapy adherence on future injury or illness work leaves. The majority of work leaves in the 2-year follow-up period occurred in the acute phase of treatment (71.2%). Among patients without a work leave in the acute phase and who received antidepressants and/or psychotherapy (n = 19,994), those who were adherent to antidepressant or psychotherapy treatment in the acute phase had a 16% (HR = 0.84, 95% CI = 0.77–0.91) reduced risk of a future work leave compared to treatment non-adherent patients. Patients who were non-adherent or adherent to antidepressant treatment had a 22% (HR = 1.22, 95% CI = 1.11–1.35) and 13% (HR = 1.13, 95% CI = 1.01–1.27) greater risk of a future work leave, respectively, than patients not receiving antidepressant treatment. Conversely, patients who were non-adherent or adherent to psychotherapy treatment had a 9% (HR = 0.91, 95% CI = 0.81–1.02) and 28% (HR = 0.72, 95% CI = 0.64–0.82) reduced risk of a future work leave, respectively, than patients not receiving psychotherapy treatment. This analysis suggests that treatment adherence may reduce the likelihood of a future work leave for patients with newly diagnosed major depressive disorder. Psychotherapy appears more effective than antidepressants in reducing the risk of a future work leave.

中文翻译：

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抗抑郁药物和心理治疗依从性对重度抑郁症患者未来工作的影响。


抑郁症是导致全球残疾的最大因素。本研究的目的是了解抗抑郁药物和心理治疗依从性对重度抑郁症患者未来工作假期的影响。 IBM® Watson™ MarketScan® 医疗和残疾索赔数据库中确定了新诊断的重度抑郁症患者 (n = 26,256)。在治疗急性期（即抑郁症诊断后 114 天）评估抗抑郁和心理治疗依从性指标。多变量 Cox 比例风险回归模型评估了抗抑郁药物和/或心理治疗依从性对未来受伤或疾病休假的影响。两年随访期间，大部分工作休假发生在治疗急性期（71.2%）。在急性期没有休假且接受抗抑郁药物和/或心理治疗的患者中 (n = 19,994)，那些在急性期坚持抗抑郁药物或心理治疗的患者的死亡率为 16% (HR = 0.84，95% CI = 0.77–0.91) 与治疗不依从的患者相比，未来工作休假的风险降低。不坚持或坚持抗抑郁治疗的患者未来工作的风险分别增加 22%（HR = 1.22，95% CI = 1.11–1.35）和 13%（HR = 1.13，95% CI = 1.01–1.27）分别比未接受抗抑郁治疗的患者离开。相反，不坚持或坚持心理治疗的患者发生心理治疗的风险分别降低了 9%（HR = 0.91，95% CI = 0.81–1.02）和 28%（HR = 0.72，95% CI = 0.64–0.82）。未来工作休假分别比未接受心理治疗的患者要少。 该分析表明，坚持治疗可能会降低新诊断出的重度抑郁症患者未来休假的可能性。在降低未来休假的风险方面，心理治疗似乎比抗抑郁药物更有效。