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Objective: Heterogeneity of depression experiences has led to suggestions that interventions focus on depression symptom combinations rather than depression severity alone. Our analyses explore the question, "What is the relationship between different combinations of depression symptoms and work productivity losses?" Methods: These analyses use a population-based sample of 2219 working adults. Using the PHQ-8 items, cluster analysis methods were used to identify depression symptom clusters. The Work Limitations Questionnaire's four work productivity loss dimensions were regressed on the identified depression symptoms clusters. Results: The symptoms clusters of workers with mild to moderate depression had significant but similar work productivity losses. However, the symptom combinations within these clusters of workers varied. Conclusion: To create effective work accommodations, attention should focus on the combinations of depression symptoms and specific job characteristics rather than severity alone. [ABSTRACT FROM AUTHOR]

Objective: Employers have increasingly been interested in decreasing work stress. However, little attention has been given to recovery from the exertion experienced during work. This paper addresses the question: how does the presence of high need for recovery (HNFR) affect the association between perceived high chronic exposure to stressful work demands (PHCE) and work productivity loss (WPL)? Methods: Data were from a population-based survey of 2219 Ontario workers. The Work Limitations Questionnaire was used to measure WPL. The relationship between HNFR and WPL was examined using four multiple regression models. Results: Our results indicate that HNFR affects the association between PHCE and WPL. They also suggest that PHCE alone significantly increases the risk of WPL. Conclusion: Our results suggest that HNFR as well as PHCE could be an important factor for workplaces to target to increase worker productivity. [ABSTRACT FROM AUTHOR]

Objective: This article estimates the decrease in workplace productivity losses associated with removal of three types of barriers to mental health service use among workers with depression. Methods: A model of productivity losses based on the results of a population-based survey of Canadian workers was used to estimate the impact of three types of barriers to mental health service use among workers with depression. Results: Removing the service need recognition barrier is associated with a 33% decrease in work productivity losses. There is a 49% decrease when all three barriers are removed. Conclusions: Our results suggest recognizing the need for treatment is only one barrier to service use; attitudinal and structural barriers should also be considered. The greatest decrease in productivity losses is observed with the removal of all three barriers. [ABSTRACT FROM AUTHOR]

Objective: This article estimates the net benefit for a company incorporating a collaborative care model into its return-to-work program for workers on short-term disability related to a mental disorder. Methods: Employing a simple decisions model, the net benefit and uncertainty were explored. Results: The breakeven point occurs when the average short-term disability episode is reduced by at least 7 days. In addition, 85% of the time, benefits could outweigh costs. Conclusions: Model results and sensitivity analyses indicate that organizational benefits can be greater than the costs of incorporating a collaborative care model into a return-to-work program for workers on short-term disability related to a mental disorder. The results also demonstrate how the probability of a program's effectiveness and the magnitude of its effectiveness are key factors that determine whether the benefits of a program outweigh its costs. [ABSTRACT FROM AUTHOR]

Objective: Economic evaluations commonly accompany trials of new treatments or interventions; however, regression methods and their corresponding advantages for the analysis of cost-effectiveness data are not well known. Methods: To illustrate regression-based economic evaluation, we present a case study investigating the cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders. We implement net benefit regression to illustrate its strengths and limitations. Results: Net benefit regression offers a simple option for cost-effectiveness analyses of person-level data. By placing economic evaluation in a regression framework, regression-based techniques can facilitate the analysis and provide simple solutions to commonly encountered challenges. Conclusions: Economic evaluations of person-level data (eg, from a clinical trial) should use net benefit regression to facilitate analysis and enhance results. [ABSTRACT FROM AUTHOR]

The article presents a study on the factors affecting the length of short-term disability-free period among workers with previous episodes of short-term disability due to physical or mental illness. The study uses a dataset of 3593 workers in Canada from January 1, 2003 - January 3, 2007. Results show that factors including marriage, sex, and union membership affect the duration, while those who had mental disorders had shorter disability-free days than those who had physical disorders.

The article presents an investigation on the comparative incidence and costs of physical and mental health-related disabilities in an employed population. The data comes from a Canadian resource sector company's 2003-2006 short-term disability leave and human resource data sets which concentrate on episodes that started from 2003-2005. It mentions respiratory disorder, musculoskeletal disorder and mental or behavioral disorder as the top categories.

The article presents a study which explores factors linked with a mental and behavioral disorder-related short-term disability episode versus physical disorder-related disability episode using administrative longitudinal data. In figuring the association between worker characteristics and various types of disability episodes, logistic regression models were used. The results show that a history of a previous disability episode is one of the critical factors associated with disability episode.

Presents a study that examined the prevalence of short-term disability due to depression in an employed population in Canada. Characteristics of the workers affected with short-term disability due to depression; Analysis of the short-disability outcomes of Canadian employees; Assessment of the severity of the depression of the workers.

Objectives: To examine the influence of depression and/or anxiety on work leaves and the impact of work leaves on experiencing a new-onset depression and/or anxiety disorder., Methods: IBM's MarketScan® research databases were linked to investigate depressive and anxiety disorders in workers with a work leave due to an injury or non-mental health illness (n = 467,930) and without a work leave (n = 2,764,447)., Results: The odds of a work leave within a year were 2.10 times higher (95%CI: 2.08-2.13) in individuals with depression and/or anxiety compared to those without. The odds of developing a new-onset depression and/or anxiety within a year was 4.21 times higher (95% CI: 4.14-4.27) in individuals with a work leave compared to those without., Conclusion: Depression and anxiety are both risk factors for and subsequent outcomes of injuries or illnesses that require a work leave.

Background: Since the FDA Black box warning in 2004, there has been a 58% drop in antidepressant use among children and adolescents with depression. Paralleling this decrease is an associated increase in completed suicides in youth. To date, no study has examined, on a clinician level, the changes in practice that have occurred subsequent to the FDA warning., Objective: To examine changes in pediatrician clinical practice resulting from the FDA warning on antidepressants., Methods: Subjects were recruited through a national program sponsored by the Canadian Pediatric Society that regularly surveys practicing pediatricians. The mail survey inquired about knowledge of the Black-box warning, whether their practice changed and reasons for changes in prescribing practices with antidepressants after the warning. We surveyed a total of 2395 pediatricians in Canada., Results: Of the 1748 eligible pediatricians, 670 (38%) responded.Seventy-two percent (n = 484) of respondents were aware of the FDA warning. Of the 484 respondents who were aware of the warning, 80% (n = 386) changed their prescribing practices including 32% (n = 154) who followed their patients more closely. Seven percent (n = 35) stopped treatment with SSRIs in at least one patient. Physicians who had observed worsening depression/suicidality were more likely to discontinue treatment with SSRI's compared to those who had not observed these side effects previously (25% versus 6%, p < 0.001)., Conclusion: This is the first national study to examine individual pediatrician practice changes in antidepressant use subsequent to the FDA warning. Further research is needed to better understand the reasons for these changes to aid in the development of strategies that could help clinicians to optimally integrate these warnings into clinical practice.