Research Associate University of Maryland School of Pharmacy, Baltimore, Maryland, USA Baltimore, United States
Background: Major depressive disorder (MDD) symptoms can lead to reduced productivity, even among individuals treated with antidepressant medication. Limited studies have examined reported productivity among adults using antidepressants for MDD.
Objectives: To examine whether adults with MDD who are not taking antidepressants are more likely than those who are taking antidepressants to report reduced productivity.
Methods: This cross-sectional study uses data from a 2022 survey of US adults >18 years-old with MDD. We recruited 300 adults across the US via researchmatch.org. Our sampling strategy targeted diverse racial and ethnic groups. We excluded those diagnosed with bipolar, psychotic, or cognitive disorder, or post-partum depression and those residing in an institutional setting (e.g., residential setting). We excluded 55 participants who self-reported being disabled. The survey asked about socio-demographics, depression severity (PHQ-9), disability, and treatments used for depression. We defined reduced productivity, using the Sheehan Disability Scale, as >2 days in the past week feeling so impaired by depression symptoms that productivity was reduced or as ≤2 days (reference). Antidepressant use was categorized as 0, 1, >2 medications used at the time of survey. We calculated the proportion with reduced productivity and used logistic regression to estimate the odds ratio (OR) and the 95% confidence intervals (CI) between reduced productivity and antidepressant treatment. Models were adjusted for non-medication treatment (e.g., cognitive behavioral therapy, psychotherapy), depression severity, other mental health diagnoses (e.g., anxiety), other non-mental health conditions (e.g., diabetes, asthma), and demographics (age, sex, race, and employment status).
Results: Our sample of 244 adults with MDD was mainly 30-49 years-old (40.8%), female (65.3%), graduate/college degree (76.7%), and employed (66.5%). Overall, 90 (37%) reported ≤2 days, and 154 (63%) reported >2 days of reduced productivity. At the time of survey, 23.7% reported not having medicines to treat depression, 53.5% reported 1 medication, and 22.8% >2 medications. Reduced productivity was reported by 67.2% of those without medication, 60.7% of participants with 1 medication, and 64.3% with >2 medications. Participants reporting 1 (adjusted OR = 0.77, 95% CI: 0.35-1.69) or >2 medications (adjusted OR = 1.04, 95% CI: 0.42-2.59) were equally likely to report reduced productivity compared to those not taking medication. Depression severity was the only covariate associated with reduced productivity.
Conclusions: Reduced productivity due to depression symptoms and impairment among adults with MDD persists despite use of >1 antidepressant medication.
