The Prevalence and Impact of Depression in Self-Referred Clients Attending an Employee Assistance Program

Utilization of an Employee Behavioral Health Program and Its Effects on Outcomes for Depression and Anxiety Disorders

OBJECTIVE

To examine the impact of an employer-sponsored behavioral health program on depression and anxiety by assessing dose effect of psychotherapy.

METHODS

A retrospective data analysis of patients with baseline scores more than or equal to 10 on the Patient Health Questionnaire (PHQ9) or the Generalized Anxiety Disorder 7-item scale (GAD7). Survival analyses were conducted to assess whether those with a higher number of therapy sessions per episode (dose) achieved faster response (score reduction by 50% or below 10).

RESULTS

Patients with medium (8 to 12 visits) or high (more than 12 visits) dose achieved faster response than those with low dose (less than eight visits; hazard ratios more than 1.5, P < 0.05). No significant difference was found between the medium and high dose.

CONCLUSION

Higher dose of psychotherapy is correlated with improved behavioral health outcomes, although there appears to be no incremental benefit beyond a certain level.

Internal consistency and concurrent validity of the Montreal Cognitive Assessment in individuals with major depressive disorder

This study aimed to determine the internal consistency and concurrent validity of the Montreal Cognitive Assessment (MoCA), as well as its subtests, in patients with major depressive disorder (MDD). Participants were patients with DSM-IV MDD aged between 21 and 65 years. Neurocognitive function was assessed by using the MoCA and 12 neurocognitive tests. The composite z-score of 12 neurocognitive tests, which indicated the global cognitive performance, was calculated. Participants were 57 outpatients with MDD. Except the MoCA Orientation, each of the MoCA subtests showed a wide range of scores. The average inter-item correlation and the Cronbach's alpha of MoCA were 0.24 and 0.64, respectively. The MoCA total score was significantly and highly associated with the composite z-score of 12 neurocognitive tests (Pearson's r=0.78, p<0.001). The score of each MoCA subtest was significantly and moderately correlated with the z-score of its analogous neuropsychological test (absolute Spearman's r_s's=0.33-0.56, p's≤0.01). The MoCA and its subtests are reliable and valid for assessing global and specific cognitive performance in patients with MDD and could be a tool for screening neurocognitive deficits in depressed patients.

Impact of Employee Assistance Services on Depression, Anxiety, and Risky Alcohol Use: A Quasi-Experimental Study

OBJECTIVE

To test the impact of Employee Assistance Programs (EAPs) on reducing employee depression, anxiety, and risky alcohol use, and whether improvements in clinical symptoms lead to improved work outcomes.

METHODS

The study used a prospective, quasi-experimental design with propensity score matching. Participants (n = 344) came from 20 areas of state government. EAP (n = 156) and non-EAP (n = 188) employees were matched on baseline demographic, psychosocial, and work-related characteristics that differentiate EAP from non-EAP users. Follow-up surveys were collected 2 to 12 months later (M = 6.0).

RESULTS

EAP significantly reduced symptoms of depression and anxiety, but not at-risk alcohol use. EAP reductions in depression and anxiety mediated EAP-based reductions in absenteeism and presenteeism.

CONCLUSIONS

EAPs provide easy-to-access work-based services that are effective at improving employee mental health.