Programme no. 243-OP
Public Health
ADAS - On antidepressants effect on return to work in depression, anxiety and stress-related mental illness.
Ingmarie Skoglund*1, Cecilia Björkelund2, Dominique Hange3
1Medicine,Gothenburg,Sweden, 2Medicine,Gothenburg,Sweden, 3Medicine,Gothenburg,Sweden
* = Presenting author
Objectives: This application is a prospective clinical observational study of approximately 180 individuals in 2013-2014 with sick leave due to anxiety and depression diagnoses including stress-related disorders in VG region.
Background: A Swedish register-based study suggests that pharmacological treatment of depression, anxiety and stress-related disorders entail longer sick leave and higher frequency of non-temporary sickness benefits than other therapies. These findings need to be clinically verified to be able to distinguish between different diagnostic groups, severity of symptoms, and the state with co morbidity. In the region Västra Götaland (VG), unlike most regions in Sweden, the availability of psychological therapies in primary care is enough to make psychological therapy a real alternative to pharmacological. Therefore, it is likely that psychological and pharmacological therapies largely are divided along the current guidelines in collaboration with the patient. The study will have ample opportunity to answer the question whether people sick signed with the diagnoses that are in focus and who during any part of the period of illness are treated with medicines (for depression and anxiety) returns later to work and increasingly receives indefinite sick leave than people treated with psychological therapy (CBT, or otherwise) or other therapy.

Results: The study is now running at 25 health care centres. About 130 patients are included; the responses at three months is 59 and at six months 37.
Material/Methods: The individuals who declare their willingness to participate in the study undergo an initial diagnostic procedure for the enforcement of diagnosis, symptoms depth and seriousness, and assessment of potential co morbidity and ongoing medication and / or therapy. During the study repeated evaluations will be made of inconvenience depth and severity. Details of medication, therapy, and sick leave data will be continuously collected.
Conclusion: The study will make it possible to evaluate if the group treated with the antidepressant pharmacological therapy is different from the group not treated with pharmacologic therapy.
Points for discussion: If patients treated with pharmacological treatment towards diagnoses in focus would entail longer sick leave and higher frequency of non-temporary sickness benefits than other therapies - what could the causes be?