Anti-depressants are more effective for some occupational levels than others.
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People with higher status jobs may not respond as well to anti-depressants, according to a new study.
It’s already well established in research that up to 1/3rd of people treated with anti-depressant medication for depression do not respond to their drugs.
Knowing which groups don’t respond could help clinicians understand which treatments are best for each person.
In the case of workers, it may also enable employers to take steps to ease stressful conditions.
The study looked at 654 working adults attending clinics for depression.
The research found that treatment with anti-depressants was not effective for:
- 55.9% in the highest occupational group;
- 40.2% of the middle-level workers; and
- 44.3% of the low-level workers.
Differences were also found in the degree of remission (i.e. getting better) with only around 1 in 6 in remission in the higher status group as against around 1 in 4 for the other groups.
Researcher Professor Siegfried Kasper said:
Though these findings should be considered preliminarily, they indicate that high occupational levels may be a risk factor for poor response to treatment.
Of the 654 working adults in the study 336 (51.4%) held high occupational level jobs, 161 (24.6%) middle-level, and 157 (24%) low level.
Around two-thirds of the patients were female (65.6%), which is similar to the normal gender difference in reported depression.
Most patients were treated with SRIs (Serotonin Reuptake Inhibitors), although other drugs and psychotherapy was also used.
Professor Eduard Vieta, Chair of the Department of Psychiatry and Psychology, Hospital Clinic, University of Barcelona, commented:
The results of this study might sound counterintuitive, but people with highly demanding jobs are subject to a lot of stress, and when they breakdown with depression it may be particularly difficult to cope with their previous life.
An alternative explanation, which cannot be ruled out given the naturalistic design of the study, is that high-status job patients may be more prone to request psychosocial treatments without the support of pharmacotherapy.
The ideal treatment of depression is, in general, the combination of both pharmacotherapy and psychotherapy.
The study was published in European Neuropsychopharmacology (Mandelli et al., 2016).
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