Researchers believe the findings may have implications for clinicians and their patients, employers, and policymakers.
Investigators presented their results at the annual conference of the European College of Neuropsychopharmacology (ECNP) in Vienna, with findings also appearing in the journal European Neuropsychopharmacology.
Investigators explain that up to one-third of patients who receive drug therapy for depression do not respond to treatment. Knowing which groups are less likely to respond to medications could help clinicians understand which treatments are appropriate to which person.
In the case of workers, it may also enable employers to take steps to ease stressful conditions. Although there is a wealth of research showing that low social and economic status is associated with a greater risk of depression, there has been little work focusing on how occupational levels respond to treatment.
A group of international researchers from Belgium, Italy, Israel, and Austria enlisted 654 working adults attending clinics for depression, and classified their work according to occupational level. 336 (51.4 percent) held high occupational level jobs, 161 (24.6 percent) middle-level, and 157 (24 percent) low level.
Around two-thirds of the patients were female (65.6 percent), which reflects the normal gender difference in reported depression. Most patients were treated with SSRIs (selective serotonin reuptake inhibitors), although other pharmaceutical agents were also used, as well as psychotherapy.
Those in the higher levels were found to have received fewer SSRIs and more psychotherapy.
Investigators analyzed treatment outcomes for each sector and found that 55.9 percent in the highest occupational group were resistant to treatment. In contrast, only 40.2 percent of the middle-level workers remained treatment resistant, and 44.3 of the low-level workers.
This difference was also reflected in the degree of remission, with only around one in six in remission in the higher status group, as against around one in four for the other groups.
Dr. Siegfried Kasper of Vienna commented, “Though these findings should be considered preliminary, they indicate that high occupational levels may be a risk factor for poor response to treatment.
“A number of variables may explain these findings. For example, there may be specific working environment demands and stressors; people may find it difficult to accept or cope with illness, or to continue with medication; or there may be other factors, related for example to cognitive, personality, and behavioral differences.”
Researcher Dr. Joseph Zohar said, “This shows that the need for precise prescribing is not only related to the symptoms and genetics but also to occupational level; one might need to prescribe different medication for the same disorder and need to take into account the occupational level in order to reach optimum effect.”