Article Details

Research Database: Article Details

Citation:  Schene, A, Koeter, M., Kikkert, M., Swinkels, J., & Crone, P. (2007). Adjuvant occupational therapy for work-related major depression works: randomized trial including economic evaluation. Psychological Medicine, 37 (3), 351-362.
Title:  Adjuvant occupational therapy for work-related major depression works: randomized trial including economic evaluation
Authors:  Schene, A, Koeter, M., Kikkert, M., Swinkels, J., & Crone, P.
Year:  2007
Journal/Publication:  Psychological Medicine
Publisher:  Cambridge Press
DOI:  https://doi.org/10.1017/S0033291706009366
Full text:  http://proxy.library.vcu.edu/login?url=http://journals.cambridge.or...   
Peer-reviewed?  Yes
NIDILRR-funded?  No
Research design:  Randomized controlled trial

Structured abstract:

Background:  Major depression has far-reaching consequences for work functioning and absenteeism. In most cases depression is treated by medication and clinical management. The addition of occupational therapy (OT) might improve outcome.
Purpose:  The purpose of the study was to determine the cost-effectiveness of the addition of OT to treatment as usual (TAU).
Setting:  Study was conducted as part of the Programme for Mood Disorders of the Department of Psychiatry on the Academic Medical Centre in Amsterdam.
Study sample:  The study sample included 62 adults. The inclusion criteria were: age above 18 years, major depressive disorder, single episode or recurrent, without psychotic features, no history of psychos, manic, hypo-manic or cyclothymic features, no history of alcohol abuse or dependence, and additional criteria.
Intervention:  Sixty-two adults with major depression and a mean absenteeism of 242 days were randomized to TAU (out-patient psychiatric treatment) or TAU plus OT [6 months, including (i) diagnostic phase with occupational history and work reintegration plan, and (ii) therapeutic phase with individual sessions and group sessions]. Main outcome domains were depression, work resumption, work stress and costs. Assessments were at baseline and at 3, 6, 12 and 42 months.
Control or comparison condition:  Treatment as usual was the standard out- patient treatment for depression. This consisted of clinical management and antidepressants, if indicated and accepted by patients, according to standard treatment algoruthm.
Data collection and analysis:  Treatment effect of OT was tested using the t test for continuous measures and the chi-squared test for categorical variables. For longitudinal analysis, the generalized estimating equations method for dichotomous outcomes and a generalized linear model approach for continuous outcomes was used.
Findings:  The addition of OT to TAU: (i) did not improve depression outcome, (ii) resulted in a reduction in work-loss days during the first 18 months, (iii) did not increase work stress, and (iv) had a 75.5% probability of being more cost-effective than TAU alone.
Conclusions:  Addition of OT to good clinical practice does not improve depression outcome, improves productivity without increasing work stress and is superior to TAU in terms of cost-effectiveness

Disabilities served:  Depression
Populations served:  Gender: Female and Male
Interventions:  Other
Outcomes:  Other