What are the predictors of work impairment in Iranian patients with depressive disorders?

The purpose of this study is to estimate the predictors of working ability in depressed patients. Two hundred and twenty-six patients with depression consecutively admitted on outpatient basis from March 2003 to May 2006 were classified into working and non working groups. Severity of depression was measured by the Beck Depression Inventory and their occupational adjustment 2 months prior to the last episode was determined by Occupational Adjustment Scale, a subscale of Social Adjustment Scale. The groups were almost similar in terms of age, sex, education, and marital status. There were significant differences between them in terms of family history of depression, episodes of depression, history of suicide attempts, duration of illness and severity of depression (P < 0.01). The working depressed group differed significantly from the impaired depressed group in terms of work experience, job turnover, and overall occupational adjustment (P < 0.01). History of suicide attempt, family history of depression, time lost, severity of depression, pre-morbid occupational adjustment, age, and illness duration emerged as the most important predictors, explaining 64% of the patients' working ability. Our observations are on line with robust literature across the globe. Nature of illness condition as well as societal attitude can explain the impairment condition in depressed patients. Presence of a comprehensive integrated approach to their treatment and rehabilitation is imperative.