Skip to main content
Log in

Predicting factors for absenteeism in patients with major depressive disorders

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

This study examines the predicting factors for absenteeism in depressed patients. Using a ‘cross-sectional’ design, we observed 345 patients diagnosed with major depressive disorders as assessed by the Diagnostic and Statistical Manual for Mental Disorders, third edition revised (DSM-III-R) criteria and Hamilton Depression Rating Scale (HAM-D) [12] score higher than 12. The treatment group (n = 268) were treated with antidepressants (n = 98 with fluoxetine and n = 170 with tricyclics [amitriptyline, clomipramine]) for at least one week and the non treated group (n = 67) had not received antidepressants for at least one month. Socio- demographic, clinical and therapeutic data was collected. The primary endpoint was absenteeism from work. Logistic regression analysis of these data was used to identify potential predictive variables. The rate of absenteeism from work was greater in non treated (70.2%) compared to treated patients (39.8% for fluoxetine group and 57.7% for tricyclics group). The risk of absenteeism for patients treated with tricyclics was 2.45 times greater than for patients treated with fluoxetine (odds-ratio = 2.45, CI 95% = 1.1—4.7). For all patients, the strongest predictors of absenteeism from work were symptom severity (odds-ratio = 44.4, CI 95% = 7.9—250) followed by past history of depression (odds-ratio = 6.85, CI 95% = 2.6–18.4) and past history of absenteeism (odds-ratio = 6.51, CI 95% = 2.0—204). In conclusion, the risk of absenteeism from work increases with depression severity and is higher with tricyclics compared to fluoxetine.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American Psychiatric Association. Committee on nomenclature and statistics. Diagnostic and statistical manual of mental disorders, 3rd edn, revised. Washington DC, 1987.

  2. Baldessarini RJ. Current status of antidepressants: Clinical pharmacology and therapy. J Clin Psychiat 1989; 50: 117–126.

    Google Scholar 

  3. Boyer WF, Feighner JP. Selective serotonin reuptake inhibitors: The clinical use of citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline. In: Perspectives in psychiatry. Toronto: J. Wiley & Sons, 1991: 119–132.

    Google Scholar 

  4. Broadhead WE, Blazer DG, George LK, Tse CK. Depression, disability and days lost from work in a prospective epidemiologic survey. JAMA 1990; 264: 2524–2528.

    Google Scholar 

  5. Brown GL, Ebert ME, Goyer PF, et al. Aggression, suicide and serotonin: Relationships to CSF amine metabolites. Am J Psychiatry 1982; 139: 741–746.

    Google Scholar 

  6. Caisse Nationale d'Assurance Maladie. Statistiques annuelles. Paris, 1991.

  7. Cohen P, Cohen J. The clinician's illusion. Arch Gen Psychiatry 1984; 41: 1178–1182.

    Google Scholar 

  8. Croog SH, Levine S, Testa MA, et al. The effects of antihypertensive therapy on quality of life. N Engl J Med 1986; 314: 1657–1664.

    Google Scholar 

  9. Dew MA, Bromet EJ, Schulberg HC, Parkinson DK, Curtis EC. Factors affecting service utilisation for depression in a white collar population. Soc Psychiat Epidem 1991; 26: 230–237.

    Google Scholar 

  10. Feinstein AR (ed). Clinical epidemiology — the architecture of clinical research Philadelphia: W.B. Saunders Company, 1985.

    Google Scholar 

  11. Hamilton M. The assessment of anxiety states by rating. Brit J Med. Psychol 1959; 32: 50–55.

    Google Scholar 

  12. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 52–62.

    Google Scholar 

  13. Hodgson TA, Meiners MR. Cost-of-illness methodology: A guide to current practices and procedures. Milbank Quart 1982; 60: 429–462.

    Google Scholar 

  14. Holford TH, White C, Kelsey JL. Multivariate analysis fro matched case-control studies. Am J Epidemiol 1978; 107: 245–256.

    Google Scholar 

  15. Institut National de la Statistique et des Etudes Economiques, Paris. Enquête sur l'emploi, mars 1989: démographie et société. INSEE Bulletin 1991; 5: 22–50.

    Google Scholar 

  16. Johnson J, Weissman MM, Klerman GL. Service utilisation and soical morbidity associated with depressive symptoms in the community. JAMA 1992; 267: 1478–1483.

    Google Scholar 

  17. Kaplan RD, Mann JJ. Altered platelet serotonin uptake kinetics in schizophrenia and depression. Life Sci 1982; 31: 583–588.

    Google Scholar 

  18. MacCombs JS, Nichol MB, Stimmel GL, et al. The cost of antidepressant drug therapy failure: A study of antidepressant use patterns in a medicaid population. J Clin Psychiat 1990; 51(suppl 6): 60–71.

    Google Scholar 

  19. MacFarland BH, Freeborn DK, Mullooly JP, Pope CR. Utilization patterns among long-term enrollees in a prepaid group practice health maintenance organization. Med Care 1985; 23: 1221–1233.

    Google Scholar 

  20. Mintz J, Mintz LI, Arruda MJ, Hwang SS. Treatment of depression and the functional capacity to work. Arch Gen Psychiatry 1992; 49: 761–768.

    Google Scholar 

  21. Morris JB, Beck AT. The efficacy of antidepressant drugs: A review of research (1958–1972). Arch Gen Psychiatry 1974; 30: 667–674.

    Google Scholar 

  22. Riskind JH, Beck AT, Berchick RJ, et al. Reliability of DSM-III diagnoses for major depression and generalized anxiety disorder using the structured clinical interview for DSM-III. Arch Gen Psychiatry 1987; 44: 817–820.

    Google Scholar 

  23. Soubrie P. Reconciling the role of central serotonin neurons in human and animal behavior. Behav Brain Sci 1986; 9: 319–364.

    Google Scholar 

  24. Souêtre E, Martin P. Clinical economics and psychiatry. In: HL Freeman (ed), The uses of fluoxetine in clinical practice. London: Royal Society of Medicine Services International Congress and Symposium Series 183, 1991: 67–74.

  25. Spilker B. Quality of life assessments in clinical trials. New York: Raven Press, 1990.

    Google Scholar 

  26. Stark P, Hardison CD. A review of multicenter controlled studies of fluoxetine vs imipramine and placebo in outpatients with major depressive disorder. J. Clin. Psychiat 1985; 46: 53–58.

    Google Scholar 

  27. Stewart AL, Greenfield S, Hays RD, et al. Functional status and well-being of patients with chronic conditions: Results from the Medical Outcomes study. JAMA 1989; 262: 907–913.

    Google Scholar 

  28. Stoudemire A, Frank R, Hedemark N, et al. The economic burden of depression. Gen Hosp Psychiat 1986; 8: 387–394.

    Google Scholar 

  29. Strauss JS, Carpenter WT Jr. The prediction of outcome in schizophrenia — characteristics of outcome. Arch Gen Psychiat 1972; 27: 739–746.

    Google Scholar 

  30. Strom BL (ed). PharmacoEpidemiology. New York; Churchill Livingstone, 1989.

    Google Scholar 

  31. Van Praag HM, Asnis GM, Kahn RS, et al. Nosological tunnel vision in biological psychiatry — a place for a functional psychopathology. Ann NY Acad Sci 1990; 600: 501–510.

    Google Scholar 

  32. Weissman MM, Myers JK, Thompson WD. Depression and its treatment in a US urban community: 1975–1976. Arch Gen Psychiat 1981; 38: 417–421.

    Google Scholar 

  33. Wells KB, Stewart A, Hays RD. The functioning and well-being of depressed patients — results from medical outcomes study. JAMA 1989; 262; 914–919.

    Google Scholar 

  34. Zohar J, Insel TR, Zohar-Katouch RC, Murphy DL. Serotoninergic responsivity in obsessive compulsive disorder. Arch Gen Psychiatry 1987; 44: 946–951.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Souêtre, E., Lozet, H. & Climarosti, I. Predicting factors for absenteeism in patients with major depressive disorders. Eur J Epidemiol 13, 87–93 (1997). https://doi.org/10.1023/A:1007397913193

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007397913193

Navigation