Sick leave duration as a potential marker of functionality and disease severity in depression

Volz, Hans-Peter and Bartečků, Elis and Bartova, Lucie and Bessa, João and De Berardis, Domenico and Dragasek, Josef and Kozhuharov, Hristo and Ladea, Maria and Lazáry, Judit and Roca, Miquel and Usof, Grigory and Wichniak, Adam and Godman, Brian and Kaspar, Siegfried (2022) Sick leave duration as a potential marker of functionality and disease severity in depression. International Journal of Psychiatry in Clinical Practice. ISSN 1365-1501 (https://doi.org/10.1080/13651501.2022.2054350)

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Abstract

Objective: To discuss the impact of depression on work and how depression-related sick leave duration could be a potential indicator and outcome for measuring functionality in depression. Methods: Our review was based on a literature search and expert opinion that emerged during a virtual meeting of European psychiatrists that was convened to discuss this topic. Results: Current evidence demonstrates that depression-related sick leave duration is influenced by multiple disease-, patient- and work-related factors, together with societal attitudes towards depression and socioeconomic conditions. A wide variety of pharmacological and non-pharmacological treatments and work-based interventions are effective in reducing depression-related sick leave duration and/or facilitating return to work. Recent real-world evidence showed that patients treated with antidepressant monotherapy appear to recover their working life faster than those receiving combination therapy. Although depression-related sick leave duration was found to correlate with severity of depressive symptoms, it cannot be used alone as a viable marker for disease severity. Conclusions: Given its multifactorial nature, depression-related sick leave duration is not on its own a viable outcome measure of depression severity but could be used as a secondary outcome alongside more formal severity measures and may also represent a useful measure of functionality in depression. Key points Depression in the working population and depression-related sick leave have a profound economic impact on society Depression-related sick leave duration is influenced by multiple disease-, patient- and work-related factors, together with societal attitudes towards depression and socioeconomic conditions A wide variety of pharmacological and non-pharmacological treatments and work-based interventions have been shown to be effective in reducing depression-related sick leave duration and/or facilitating return to work In terms of pharmacological intervention, recent real-world evidence has shown that patients treated with antidepressant monotherapy are able to recover their working life faster than those treated with combination therapy Although depression-related sick leave duration has been shown to correlate with severity of depressive symptoms, it is not a viable outcome measure of depression severity on its own, but could be used as secondary outcome alongside more formal clinician- and patient-rated severity measures Depression-related sick leave duration may, however, represent a viable outcome for measuring functionality in depression.