549 Preventing work disability in workers with depression; a systematic review

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IntroductionBy the year 2020, depression will be the second most burdensome illness in developed economies. In addition to its adverse individual effects, the associated workplace effects of depression are extensive. This review is provides a synthesis of the evidence to determine effective intervention approaches for managing depression in the workplace: both to help workers stay-at-work while experiencing symptoms and to return-to-work after an episode of time away from work.MethodsWe followed a systematic review process developed by the Institute for Work and Health and an adapted best evidence synthesis. Articles that met the following criteria were considered: working age individuals with depression; workplace-based interventions; including a comparison group; outcomes of work functioning, work disability, or recurrences of work disability.ResultSeven electronic databases were searched from inception up to June 2015. The review examined 8123 titles and abstracts for relevance and found 20 RCTs and seven nRCTs from various jurisdictions. These studies evaluated a range of interventions, including; cognitive-behavioural therapy (CBT), work-focused CBT, problem solving therapy (PST), work-focused PST, enhanced care delivery, coordination of services, short- and long-term psychodynamic therapy, stress reduction programs, exercise training, part-time sick leave and nature-based rehabilitation. Our findings indicate that CBT and PST interventions can help workers with depression stay-at-work while managing their symptoms; however, only work-focused CBT is sufficient to help workers return-to-work after an absence. There is currently not enough evidence from the scientific literature to guide practice for the remaining interventions identified in this review.DiscussionWe synthesised the current best evidence on workplace interventions to help employees manage symptoms of depression. The interventions identified in this review focused on strategies targeting personal resilience and coping skills of individuals with depression. More work is needed to evaluate interventions aimed at mitigating workplace factors such as psychosocial working conditions.

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