Long-term occupational outcomes in major depressive disorder: a 10-year follow-up study of symptom and comorbidity predictors.

BACKGROUND: No study has simultaneously investigated the associations of anxiety comorbidities, persistent depressive disorder (PDD), depression, anxiety, and somatic symptoms at baseline with the total and longest durations of paid employment (DPE) as well as the total number of reasons for occupational impairment (OI) over a 10-year period among patients with major depressive disorder (MDD). The study aimed to investigate these issues. METHODS: At baseline, 290 subjects with MDD were enrolled. MDD and anxiety comorbidities were confirmed using the Structured Clinical Interview for DSM-IV-TR. The Depression and Somatic Symptoms Scale and the Hospital Anxiety and Depression Scale were employed. At the 10-year follow-up point, 113 subjects were investigated. The total and longest DPE were clarified and recorded. A 28-item list was used to investigate the subjective reasons for OI. Multiple linear regression models were used for statistical analysis. RESULTS: For the total and longest DPE, 14.2% and 40.7% of the subjects were less than five years, respectively. An increase of one anxiety comorbidity in subjects was associated with a decrease of 4.6 months in the total DPE compared to those without. Subjects with greater somatic symptoms, PDD, and the female gender at baseline reported more reasons for OI. Fatigue, somatic discomfort, decreased motivation, and sensitivity to comments were common reasons for OI. CONCLUSIONS: In the treatment of depression, clinicians should pay more attention to the above treatable factors, including anxiety comorbidities, PDD, fatigue, decreased motivation, and somatic symptoms, to improve OI.