Work re-entry and functioning in people with major depression: a longitudinal study of supported employment participants.

Background: People with major depression are affected by impaired daily functioning and non-participation in the workforce. At the same time, employment has been associated with improved mental health outcomes. The aim of this study was to examine the relationship between work re-entry and subsequent functioning and depressive symptoms.

Methods: The present observational study included a sample of 129 participants of a supported employment intervention project in Germany diagnosed with depressive disorders. Participants were assessed before the start of the intervention (baseline) and after two years (follow-up). Functioning and depressive symptom severity were measured using the World Health Organization Disability Assessment Schedule 2 (WHODAS 2.0) and the Beck's Depression Inventory II (BDI-II). After multiple imputation, linear regression analyses were conducted to analyze the relationship between work re-entry and follow-up functioning and symptom severity, controlling for baseline scores and age.

Results: Work re-entry was significantly associated with better overall functioning (p =.002), cognitive functioning (p =.001) and community participation (p =.002), adjusted for baseline scores and age. A significant interaction effect (p =.001) suggested that the association between work re-entry and overall functioning at follow-up was stronger in older participants. After adjustment for baseline functioning and age, work re-entry was not significantly associated with self-care, social interaction and household responsibilities, while associations with mobility (p =.072) and symptom severity (p =.054) were marginally nonsignificant.

Conclusions: The results support the association between work re-entry and lower disability in people with depression who participated in supported employment. Certain functional domains, especially cognition and participation, may be more closely associated with becoming re-employed. The association between work-re-entry and overall functioning may be stronger in older individuals.

Trial registration: The data used for this study were collected as part of a clinical trial called "IPS-ZIB" which was prospectively registered with the German register for clinical trials on 12/14/2020 (DRKS; ID: DRKS00023521).