The effect of Remission Status on Work Functioning in Employed Patients Treated for Major Depressive Disorder
Bibliographic record
Abstract
BACKGROUND: The ability to function at work is impaired in patients with major depressive disorder (MDD) but few clinical trials include occupational outcome assessments. This study examined whether symptom remission following treatment for MDD is associated with work functioning improvement. METHODS: We conducted a secondary analysis of a 12-week randomized clinical trial comparing escitalopram with or without telephone-administered cognitive therapy in employed patients with MDD (N = 86). Outcomes included the Montgomery-Åsberg Depression Rating Scale (MADRS) and validated, self-rated work functioning scales including the Lam Employment Absence and Productivity Scale (LEAPS), Work Performance Questionnaire (HPQ), and Sheehan Disability Scale (SDS). Remission was defined as MADRS score ≤10 at 12 weeks. Data were evaluated using analysis of covariance with baseline score as covariates. RESULTS: Remission status was associated with significant improvement in work performance as assessed by the LEAPS productivity subscale, HPQ overall performance, and the SDS work/school item; a trend (P = .08) was observed with the HPQ productivity subscale. The effect sizes (d = 0.23, 0.51, 0.36, and 0.43, respectively) indicate small to medium effects that are likely clinically significant. CONCLUSIONS: The results of our study confirm that symptom remission following treatment is associated significantly with improvement in work performance and productivity, as measured by validated work functioning scales. Measurement-based care for MDD should include both symptom and functional outcome assessments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".