Depression and other mental illnesses in the context of workplace efficacy

Cognitive work hardening for return to work following depression: An intervention study: Le réentraînement cognitif au travail pour favoriser le retour au travail à la suite d'une dépression : étude d'intervention

BACKGROUND

Work absences due to depression are prevalent; however, few interventions exist to address the return-to-work challenges following a depressive episode.

PURPOSE

This mixed-methods study aimed to (a) evaluate the effectiveness of cognitive work hardening in preparing people with depression to return to work and (b) identify key elements of the intervention.

METHOD

A single group ( n = 21) pretest-posttest study design was used incorporating self-report measures (Work Ability Index, Multidimensional Assessment of Fatigue, Beck Depression Inventory II) with interviews at intervention completion and at 3-month follow-up. Descriptive statistics, paired-samples t test, and content analysis were used to analyze the data.

FINDINGS

Work ability, fatigue, and depression severity significantly improved postintervention. Participants identified structure, work simulations, realism of simulated work environment, support, and education as key intervention elements.

IMPLICATIONS

Findings underscore an occupationally focused return-to-work intervention for people recovering from depression with potential for wider adoption and future research.

The negative impact of attention-deficit/hyperactivity disorder on occupational health in adults and adolescents

PURPOSE

To review the negative effects of attention-deficit/hyperactivity disorder (ADHD) in adolescence and adulthood on work productivity and occupational health.

METHODS

A review of the MEDLINE database was carried out to identify direct and indirect effects of ADHD on work, employment and occupational health.

RESULTS

ADHD is associated with higher levels of unemployment versus controls. Adults with ADHD who are employed experience workplace impairment and reduced productivity, as well as behavioural issues such as irritability and low frustration tolerance. Adults with ADHD are also at increased risk of accidents, trauma and workplace injuries, particularly traffic accidents. Indirect effects of ADHD on occupational health include reduced educational achievement and increased rates of substance abuse and criminality. Overall, ADHD in adults has a substantial economic impact as a result of absenteeism and lost productivity. Psychoeducation, combined with stimulant medications if necessary, is recommended as first-line treatment for adults with ADHD. Limited data available suggest that stimulant treatment can improve work productivity and efficacy, and reduce the risks associated with driving, although further studies are necessary.

CONCLUSIONS

ADHD can affect the ability to gain and maintain employment and to work safely and productively. As ADHD is a treatable condition, patients, employers and physicians have a role to play in ensuring optimal occupational health.