Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, No. 291 Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan.
Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and Department of Neurology, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Soc Psychiatry Psychiatr Epidemiol. 2022 Jun;57(6):1179-1188. doi: 10.1007/s00127-022-02240-y. Epub 2022 Feb 12.
Major depressive disorder (MDD) affects a person's function of daily activities, including work participation. Such functional impairments often persist even when other symptoms of MDD are remitted. Increasing evidence highlights the health-promoting effects of returning to work (RTW) in various diseases. However, limited data are available regarding the impact of return to work on functional recovery in MDD. We explored the association between RTW and functional improvements in people with MDD using a large nationally representative database and a 3-year follow-up.
Data of people with an MDD diagnosis were selected from the Taiwan Data Bank of Persons with disability for the period between July 11, 2012, and October 31, 2018. We included 4038 adults aged 18-64 years. The World Health Organization Disability Assessment Schedule 2.0 was used for functional assessment. The association between RTW and functional improvements was investigated using a multivariable regression analysis adjusted for confounding variables.
Women aged ≥ 45 years with a lower education level were vulnerable to prolonged unemployment. RTW was significantly associated with better functional improvements in cognition, mobility, self-care, getting along, life activity, and participation than unemployment.
RTW was positively associated with functional improvements in patients with MDD. A referral system targeting re-employment may be suggested during MDD treatment, especially for individuals at risk of prolonged unemployment.
重度抑郁症（MDD）影响患者的日常活动功能，包括工作参与。即使其他 MDD 症状缓解，这种功能障碍往往仍然存在。越来越多的证据强调了重返工作岗位（RTW）在各种疾病中的健康促进作用。然而，关于重返工作岗位对 MDD 患者功能恢复的影响，数据有限。我们使用大型全国代表性数据库和 3 年随访，探讨了 MDD 患者 RTW 与功能改善之间的关联。
从 2012 年 7 月 11 日至 2018 年 10 月 31 日期间，从台湾残疾人士数据库中选择患有 MDD 诊断的人的数据。我们纳入了 4038 名 18-64 岁的成年人。使用世界卫生组织残疾评估量表 2.0 进行功能评估。使用多变量回归分析调整混杂变量来研究 RTW 与功能改善之间的关联。
年龄≥45 岁且教育程度较低的女性更容易长期失业。与失业相比，RTW 与认知、移动、自理、相处、生活活动和参与方面的更好功能改善显著相关。
RTW 与 MDD 患者的功能改善呈正相关。在 MDD 治疗期间，可能需要针对重新就业的转介系统，特别是针对那些有长期失业风险的人。
