[Time course and prognosis of industrial workers with major depression]

To investigate the time course and the prognosis of patients with depressive disorder in industry, 60 workers with major depression (DSM-III) selected from two companies were interviewed. Average follow-up years for subjects after returning to their job was 3.5, ranging from 1 to 8. About half of the subjects relapsed and two-thirds changed their job within 5 yr after returning to their job. One case committed suicide. Subjects tended to relapse within the first 4 yr and under the same precipitating situation as at their onset phase. Fifty percent of the subjects indicated "very good" or higher social adjustment according to Axis V (DSM-III). Enough rest days at the onset and no relapse significantly correlated with higher social adjustment in the subjects within 2 yr after the return. In the subjects followed-up for 3 yr or more, marital status, education, no higher occupational status, fewer relapses, and support for them by both industrial health services and worksite supervisors were found to be significant predictors of higher adjustment. The results suggested that, in order to prevent relapses and improve social adjustment of workers with major depression, the mental health team in industry should provide continuous and careful support for them, for at least 4 yr after returning to their job.