Treatments of depression and the functional capacity to work

Arch Gen Psychiatry. 1992 Oct;49(10):761-8. doi: 10.1001/archpsyc.1992.01820100005001.


This study evaluated the effects of antidepressants and psychotherapy on work impairment in depressed patients. Original databases from 10 published treatment studies were compiled and analyzed (N = 827). Functional work impairment was common at baseline, manifested by unemployment (11%) or on-the-job performance problems (absenteeism, decreased productivity, interpersonal problems, 44%). Generally, work outcomes were good when treatment was symptomatically effective, but the trajectories of work restoration and symptom remission were different, with work recovery appearing to take considerably longer. Relapse was an important determinant of long-term occupational outcome, particularly for seriously ill patients for whom relapse meant rehospitalization or other profound social disruption. Affective impairment was distinguished from functional impairment, with the former characterizing milder depression and the latter characterizing moderate to severe depression. Some methodological recommendations are discussed.

Publication types

  • Meta-Analysis
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Absenteeism
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Combined Modality Therapy
  • Depressive Disorder / psychology
  • Depressive Disorder / rehabilitation
  • Depressive Disorder / therapy*
  • Efficiency
  • Employment
  • Follow-Up Studies
  • Humans
  • Prognosis
  • Psychotherapy
  • Treatment Outcome
  • Work Capacity Evaluation
  • Work*


  • Antidepressive Agents, Tricyclic