The Impact of an Early Eclectic Rehabilitative Intervention on Symptoms in First Episode Depression among Employed People.

Objective. To evaluate the effect of an early vocational-orientated eclectic intervention on beck depression inventory (BDI) scores compared to treatment as usual in first ever depressive episode among employed people. Design. A randomized controlled trial comparing the rehabilitative intervention and the conventional treatment. Subjects. The subjects came from occupational health care units. Methods. Employees were sent to a rehabilitation center after being screened for depression using the BDI. They were diagnosed using the structured clinical interview for DSM-IV. The participating subjects (N = 283) were randomized into intervention and control groups. The intervention group received eclectic early depression intervention treatment (N = 134) and the control group was treated in the conventional way (N = 100). They were followed for one year. Results. The mean decrease in BDI scores within the intervention group was from 20.8 to 11.6 and within the control group from 19.3 to 10.8. BDI score decreased by 10 or more points in 64% of the participants in the intervention group and in 53% of the control group (P = 0.013). Conclusions. There was some evidence that early eclectic intervention in first ever episode depression may be more effective than conventional treatments among working age people in employment.

Obsessive-compulsive personality disorder is common among occupational health care clients with depression.

OBJECTIVE: To study how common personality disorders (PDs) are among employed subjects with first-episode depression. Depression is the single most common cause of working disability in Finland. Personality disorders are associated with depression. METHODS: Subjects were screened using the Beck Depression Inventory scale, with a cutoff point greater than 9. The structured clinical interview for Diagnostic and Statistical Manual, fourth revision, was used to assess mental disorders. Inclusion criterion was major depressive disorder. RESULTS: Most of the 272 participants were female (83%) and the majority (74%) were older than 40 years. The main finding was that one third of the participants had obsessive-compulsive PD. The prevalence of obsessive-compulsive PD was 50% among men and 28% in women. CONCLUSION: It is important to recognize comorbid PDs when assessing working-age persons experiencing depression.

[Vocational rehabilitation in mental disorders]. / Ammatillinen kuntoutus mielenterveyshäiriöissä.

Supporting the working careers of patients having mental disorders is in the best interest of the individual, the community and the society. In mental disorders, recovery to be able to work is more challenging than in other disease groups. Vocational rehabilitation yields the best results when implemented early enough and in close association with work. Work trial and preparation for work are among the most common means of rehabilitation supporting mental patients' return to work. Collaboration with the workplace is needed when the work and working hours are adapted to the needs of the rehabilitee. Supported employment helps even the severely ill to be able to return to work.