DEPRESSION AND PRODUCTIVE WORK ACTIVITY

描述（申请人摘要）：虽然抑郁是工作的主要原因， 在这个国家的残疾，减少残疾的努力仍然受到阻碍， 缺乏研究。这项研究的长期目标是防止由于 抑郁症一项纵向研究提出，解决在职工作 残疾的就业初级保健抑郁症患者。样品 将纳入350名患有重度抑郁症（MDD）和/或 在基线时使用，以及两个比较组：1））200 患有类风湿性关节炎（PA）的工人， 最高的工作残疾率之一; 2）100个“健康”对照。的 研究有3个具体目标：1）前瞻性评估和比较 哪四种类型的工作残疾（失业，工作时间损失，减少工作 工作时间和工作限制）; 2）确定 有助于成功和不成功的工作成果的变量， 抑郁症患者; 3）确定是否有助于变量 抑郁症和类风湿性关节炎的患病率是一样的。该项目的 健康相关性是其重点关注一个主要公共卫生问题（工作 抑郁症导致的残疾）在越来越重要的部分， 精神卫生保健提供系统（初级保健）。 受试者将从初级保健实践中招募，年龄为18-62岁， 在基准线上工作，至少两年不打算停止工作。 将从患者调查（基线和第3、6、12和14个月）中收集数据。 18）、患者图表和诊所药房记录。我们还将实施一项新的 有效的调查工具;工作限制问卷，评估 在职表现和生产力，从而捕捉工作的各个方面 失业和缺勤数据中没有反映残疾情况。 统计分析将：1）确定四种类型的大小 抑郁症样本中的工作残疾和工作生产力成本）; 2） 确定预测工作能力丧失或持续工作能力的变量; 和3）确定精神和身体疾病的不同影响， 工作残疾率，工作残疾和生产力的预测因素 成本研究结果将有助于残疾预防的设计， 提高生产力的计划和政策。

DESCRIPTION (Applicant's abstract): While depression is a leading cause of work disability in this nation, disability reduction efforts remain hampered by a lack of research. This study's long-term goal is to prevent work disability due to depression. A longitudinal study is proposed that addresses on-the-job work disability among employed primary care patients with depression. The sample will include 350 patients who have Major Depressive Disorder (MDD) and/or dysthymia and are employed at baseline, and two comparison groups: 1)) 200 workers with rheumatoid arthritis (PA), a physically limiting condition with one of the highest work disability rates; and 2) 100 "healthy" controls. The study has 3 specific aims: 1) to prospectively assess and compare the rates at which four types of work disabilities (job loss, work time loss, reduced work hours and on-the-job limitations) occur among the groups; 2) to identify variables that contribute to successful and unsuccessful work outcomes among patients with depression; 3) to determine whether the variables that contribute to work disability are the same for depression and RA. The project's health-relatedness is its focus on a major public health problem (work disability due to depression) within an increasingly important segment of the mental health care delivery system (primary care). Subjects will be recruited from primary care practices, 18-62 years of age, employed at baseline and not planning to stop working for at least 2 years. Data will be collected from patient surveys (baseline and months 3, 6, 12 and 18), patient charts and clinic pharmacy records. We will also administer a new validated survey instrument; The Work Limitations Questionnaire, which assesses on-the-job performance and productivity and, thus, captures aspects of work disability not reflected in job loss and absenteeism data. The statistical analysis will: 1) establish the magnitude of the four types of work disability and work productivity costs within the depression sample); 2) identify variables that predict work disability or a sustained ability to work; and 3) determine the differential impact of a mental and a physical illness on work disability rates, the predictors of work disability and productivity costs. Study results will contribute to the design of disability prevention and productivity improvement programs and policies.