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      Use of psychotropic drugs among workers on leave due to mental disorders

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          ABSTRACT

          Objective

          To describe the use of psychotropic drugs among civil servants with registered absenteeism due to mental disorders, and to investigate associations with duration of leave of absence.

          Methods

          A cross-sectional study with civil servants on leave of absence due to mental disorders, between January and December 2017. Demographic, occupational and clinical variables were extracted from secondary data. Non-parametric tests were used to investigate correlations between use of psychotropic drugs and leave duration. Cluster analysis was used to investigate associations between occupational characteristics and illness profile.

          Results

          Antidepressants were the most commonly used drugs (82.9%). Central tendency values for days on leave differed according to the number of psychotropic drugs used. In cluster analysis, a particular cluster (servants of intermediate age group and work experience – mean of 46 years and 15 years, respectively) stood out regarding use of antidepressants, severity of depression and frequency and duration of leave of absence.

          Conclusion

          Leave of absence due to mental disorders was associated with higher rates of psychotropic drug use. The group of servants identified in this study may be a primary target for health promotion, prevention and recovery actions at the organization.

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          Most cited references34

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          Determinants of Sickness Absence and Return to Work Among Employees with Common Mental Disorders: A Scoping Review

          Purpose To present an overview of the existing evidence on prognostic factors of (recurrent) sickness absence (SA) and return to work (RTW) among workers with a common mental disorder (CMD). This scoping review provides information about determinants for SA and RTW, which could be used to develop better interventions aimed at the prevention of SA and promotion of RTW among workers with a CMD. Methods Relevant articles were identified in PubMed, Embase, PsycINFO, PSYNDEX, and SINGLE up to October 2016. In order to be included, studies should provide insight into prognostic factors of SA or RTW of workers with a CMD. We classified all factors according to the domains of the International Classification of Functioning, Disability and Health. Results Our searches identified 2447 possible relevant articles, of which 71 were included for data extraction. There is consistent evidence in ≥3 studies that previous episodes of CMD, higher symptom severity, previous absenteeism, co-morbidity, high job demands, low job control, high job strain, female gender, lower educational level, smoking behavior, and low perceived general health are predictors of SA in people with CMDs. Earlier RTW is consistently predicted by lower symptom severity, having no previous absenteeism, younger age, and positive expectations concerning sick-leave duration or RTW. Conclusions The amount of research on determinants for SA and RTW in workers with CMD has increased dramatically in recent years, although most studies are from the Netherlands and Scandinavia. There are some research gaps identified in this scoping review that need further attention in primary and secondary studies. Based on the summary of the evidence, we provide guidance for policy, practice and research. Electronic supplementary material The online version of this article (doi:10.1007/s10926-017-9730-1) contains supplementary material, which is available to authorized users.
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            Findings from the Global Burden of Disease Study 2017

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              Increase in work productivity of depressed individuals with improvement in depressive symptom severity.

              The authors sought to identify baseline clinical and sociodemographic characteristics associated with work productivity in depressed outpatients and to assess the effect of treatment on work productivity. Employed depressed outpatients 18-75 years old who completed the Work Productivity and Activity Impairment scale (N=1,928) were treated with citalopram (20-40 mg/day) in the Sequenced Treatment Alternatives to Relieve Depression study. For patients who did not remit after an initial adequate antidepressant trial (level 1), either a switch to sertraline, sustained-release bupropion, or extended-release venlafaxine or an augmentation with sustained-release bupropion or buspirone was provided (level 2). Participants' clinical and demographic characteristics and treatment outcomes were analyzed for associations with baseline work productivity and change in productivity over time. Education, baseline depression severity, and melancholic, atypical, and recurrent depression subtypes were all independently associated with lower benefit to work productivity domains. During level 1 treatment, work productivity in several domains improved with reductions in depressive symptom severity. However, these findings did not hold true for level 2 outcomes; there was no significant association between treatment response and reduction in work impairment. Results were largely confirmed when multiple imputations were employed to address missing data. During this additional analysis, an association was also observed between greater impairment in work productivity and higher levels of anxious depression. Patients with clinically significant reductions in symptom severity during initial treatment were more likely than nonresponders to experience significant improvements in work productivity. In contrast, patients who achieved symptom remission in second-step treatment continued to have impairment at work. Patients who have demonstrated some degree of treatment resistance are more prone to persistent impairment in occupational productivity, implying a need for additional, possibly novel, treatments.
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                Author and article information

                Journal
                Einstein (Sao Paulo)
                Einstein (Sao Paulo)
                eins
                Einstein
                Instituto Israelita de Ensino e Pesquisa Albert Einstein
                1679-4508
                2317-6385
                27 May 2021
                2021
                : 19
                : eAO5506
                Affiliations
                [1 ] orgdiv1Departamento de Atenção à Saúde do Trabalhador orgnameUniversidade Federal de Minas Gerais Belo Horizonte MG Brazil original Departamento de Atenção à Saúde do Trabalhador , Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil .
                [2 ] orgdiv1Faculdade de Farmácia orgnameUniversidade Federal de Minas Gerais Belo Horizonte MG Brazil original Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil .
                [1 ] Brasil original Departamento de Atenção à Saúde do Trabalhador, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil .
                [2 ] Brasil original Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil .
                Author notes
                Corresponding author: Fabiana Vieira Garcia Leão Departamento de Atenção à Saúde do Trabalhador Universidade Federal de Minas Gerais Avenida Presidente Antônio Carlos, 6.627 Pampulha Zip code: 31270-901 – Belo Horizonte, MG, Brazil Phone: (55 31) 3409-4566 E-mail: fvieira98@ 123456gmail.com

                Conflict of interest: none.

                Autor correspondente: Fabiana Vieira Garcia Leão Departamento de Atenção à Saúde do Trabalhador Universidade Federal de Minas Gerais Avenida Presidente Antônio Carlos, 6.627 Pampulha CEP: 31270-901 – Belo Horizonte, MG, Brasil Tel.: (31) 3409-4566 E-mail: fvieira98@gmail.com

                Conflitos de interesse: não há.

                Author information
                https://orcid.org/0000-0003-2579-9296
                https://orcid.org/0000-0003-2988-5829
                https://orcid.org/0000-0003-1408-8632
                https://orcid.org/0000-0001-7083-3188
                Article
                00210
                10.31744/einstein_journal/2021AO5506
                8169027
                743af409-14d2-4c9f-ae99-187c1c4d14d4

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 November 2019
                : 3 September 2020
                Page count
                Figures: 2, Tables: 8, Equations: 0, References: 27
                Categories
                Original Article

                mental disorders,absenteeism,psychotropic drugs,antidepressive agents,government employees,depression

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