High occupational status linked to poor response to depression treatment

New research provides additional evidence that your type of employment is associated with the outcome of depression treatments. According to the study, which was published in European Neuropsychopharmacology, depressed people with higher positions at work tend to respond less well to treatment.

“In everyday clinical practice it is common to observe the burden of mentally demanding jobs in subjects who are treated for depression. In fact, for them it is more difficult to return to work when minor residual symptoms are present, which may lead to slower recovery,” said study author Alessandro Serretti, a professor of biomedical and neuromotor sciences at the University of Bologna.

“Let’s imagine a company manager who has to quickly decide the pros and cons of many decisions to take, if your concentration is not completely back this becomes a painful situation.”

The study of 647 working adults diagnosed with major depressive disorder found that those with a high status job tended to be less likely to respond to treatment. The study included 46 managers, 476 white-collar workers, 74 blue-collar workers and 51 self-employed individuals.

Managers had the worst response to treatments for depression, while blue-collar workers had the best response — even after controlling for gender, age, education, and the type of treatment received. Seventy percent of managers reported having no response to two or more depression treatments, compared to 45% of blue-collar workers and 58% of white-collar workers.

The findings replicate the results of a previous study, which was published in the journal European Neuropsychopharmacology in 2016.

“It appears that people in high occupational levels respond with greater difficulty to treatment for major depression,” the researchers wrote in a commentary for Psychological Medicine. “The reasons for this effect are not clearly established, but we can speculate that the stress factors in the workplace play a significant role.”

Serretti told PsyPost the findings indicate that “when suffering from depression, you should take your time to go back to your working activities, especially if they are mentally demanding.”

It is unclear why having a hgh occupational level is associated with poor response to treatments for depression. But high workload, pressure, competition, social isolation at work and poor work-life balance could all play a role. Future research could also examine the role of personality, family support, and self-blame.

Surprisingly, “this concept has been largely understudied,” Serretti said. “It is counterintuitive. Many think that higher status positions are usually related to better outcomes — but that is not always the case.”

The study, “High occupational level is associated with poor response to the treatment of depression: A replication study“, was authored by Laura Mandelli, Alessandro Serretti, Daniel Souery, Julien Mendlewicz, Siegfried Kasper, Stuart Montgomery, and Joseph Zohar.