Emerging research suggests monitoring work productivity can help determine whether a patient will require additional depression treatments.
Researchers at University of Texas Southwestern Medical Center found that medications improved work productivity of most participants. However, for those whose productivity increased more quickly, depression symptoms reduced significantly and they were more likely to recover over the long term.
These findings suggest that patients treated for depression and who are still having work productivity issues may need additional treatments such as exercise or cognitive therapy to overcome depression in the long term, said senior author Dr. Madhukar Trivedi.
The study gives new insight to specific aspects of depression that are not commonly evaluated, including work productivity, cognitive function, and motivation.
These insights in turn provide added urgency for doctors to personalize treatment — beyond simply prescribing antidepressants — to accelerate the path to recovery.
The study appears online in the American Journal of Psychiatry.
Researchers say the study adds to growing evidence of the need for comprehensive treatment approaches for depression and the importance of improving cognitive function, including motivation, energy, and concentration.
Among depression symptoms, energy, and concentration are most strongly associated with work productivity outcomes.
“Those who do not show early improvement in work productivity are a different group of patients than those who do,” said Trivedi.
Trivedi said a proportion of patients may need additional treatment to augment the medication. For example, patients could benefit from psychotherapy, telephone-based coaching, and/or physical exercise — all treatments that research has shown can reduce depression symptoms.
He said he intends to conduct future studies in which doctors alter treatments in a timely manner to address motivation, concentration, and work productivity, with the goal of improving success rates.
“Finding the precise formula that works for each patient will be a key part of future research — tailoring treatment for the individual patient,” he said. “One size does not fit all.”
The current study tracked work productivity and depression symptoms in 331 patients with major depression through intervals of six weeks, three months, and seven months after they started medication. Physicians have previously focused on reducing depression symptoms and assumed that work improvement would indirectly follow without additional targeted interventions.
In the current study, at six weeks, patients were divided into three groups according to how much their work productivity changed since taking medication: those who showed robust early improvement at the office, those with minimal change, and others who remained highly impaired.
Patients in the first two groups started the trial at similar levels in depression severity and work productivity, though the “robust early improvement” group had markedly lower levels of depression at both the three- and seven-month intervals.
Compared with the other two groups, those with robust early improvement in work productivity were 3-5 times more likely to achieve full remission of depression symptoms.
Researchers believe the findings will aid in the understanding of the neurobiological mechanisms and other underlying causes of depression and to discover new treatments.
Source: University of Texas Southwestern