It’s well-established that people with low social and/or economic status are at higher risk of depression, but the influence of such elements on treatment for depression is less commonly explored. A study that attempted to do just that has found that, among working adults, having a high status job may result in poorer responses to treatment and medication.
The international study recruited 654 working adults who were diagnosed with a major depressive disorder. Their work was classified according to occupational level:
- 336 (51.4%) had high level occupations
- 161 (24.6%) had middle level occupations
- 157 (24%) had low level occupations
- 429 (65.6%) were female, which was in line with normal gender differences for depression
A patient was classified as “treatment resistant” if they did not see a response to two or more previous treatment attempts, such as a course of medication or set of psychotherapy sessions. Rates of remission were also recorded. Once all treatment for the patients had completed, the results were analyzed and the following findings were made:
- 55.9% of the high level group was resistant to treatment, and had a remission rate of about 1 in 6
- 40.2% of the middle level group was treatment resistant, and had a remission rate of around 1 in 4
- 44.3% of the low level group was treatment resistant, and had a remission rate of around 1 in 4
- Most patients were treated with serotonin reuptake inhibitors and psychotherapy, though the high level group used less SRI drugs and more therapy than the others
What This Means
These findings should be considered preliminary, though they do suggest a link between high level occupations and resistance to depression treatment. Why this is the case isn’t clear and further exploration into the issue is needed. It is possible that the demands of such positions add stressful conditions that impair treatment, or that coping is harder in such a situation. The fact that medication was not used as much among this group may also play a role in the findings, since the best treatment is generally considered to be a mixture of therapy and medication.
Basically, this study suggests that those with high level jobs have a harder time responding to treatment for depression, though why this is the case and what can be done about it remains unclear.
Mandelli, L., et. al., “High occupational level is associated with poor response to treatment of depression,” European Neuropsychopharmacology, 2016; http://dx.doi.org/10.1016/j.euroneuro.2016.05.002.