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Randomized Controlled Trial
. 2012;7(4):e35330.
doi: 10.1371/journal.pone.0035330. Epub 2012 Apr 19.

Telephone cognitive-behavioral therapy for subthreshold depression and presenteeism in workplace: a randomized controlled trial

Toshi A Furukawa  1 , Masaru Horikoshi, Norito Kawakami, Masayo Kadota, Megumi Sasaki, Yuki Sekiya, Hiroki Hosogoshi, Masami Kashimura, Kenichi Asano, Hitomi Terashima, Kazunori Iwasa, Minoru Nagasaku, Louis C Grothaus; GENKI Project
Collaborators, Affiliations
Randomized Controlled Trial

Telephone cognitive-behavioral therapy for subthreshold depression and presenteeism in workplace: a randomized controlled trial

Toshi A Furukawa et al. PLoS One. 2012.

Abstract

Background: Subthreshold depression is highly prevalent in the general population and causes great loss to society especially in the form of reduced productivity while at work (presenteeism). We developed a highly-structured manualized eight-session cognitive-behavioral program with a focus on subthreshold depression in the workplace and to be administered via telephone by trained psychotherapists (tCBT).

Methods: We conducted a parallel-group, non-blinded randomized controlled trial of tCBT in addition to the pre-existing Employee Assistance Program (EAP) versus EAP alone among workers with subthreshold depression at a large manufacturing company in Japan. The primary outcomes were depression severity as measured with Beck Depression Inventory-II (BDI-II) and presenteeism as measured with World Health Organization Health and Work Productivity Questionnaire (HPQ). In the course of the trial the follow-up period was shortened in order to increase acceptability of the study.

Results: The planned sample size was 108 per arm but the trial was stopped early due to low accrual. Altogether 118 subjects were randomized to tCBT+EAP (n = 58) and to EAP alone (n = 60). The BDI-II scores fell from the mean of 17.3 at baseline to 11.0 in the intervention group and to 15.7 in the control group after 4 months (p<0.001, Effect size = 0.69, 95%CI: 0.32 to 1.05). However, there was no statistically significant decrease in absolute and relative presenteeism (p = 0.44, ES = 0.15, -0.21 to 0.52, and p = 0.50, ES = 0.02, -0.34 to 0.39, respectively).

Conclusion: Remote CBT, including tCBT, may provide easy access to quality-assured effective psychotherapy for people in the work force who present with subthreshold depression. Further studies are needed to evaluate the effectiveness of this approach in longer terms. The study was funded by Sekisui Chemicals Co. Ltd.

Trial registration: ClinicalTrials.gov NCT00885014.

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Conflict of interest statement

Competing Interests: TAF has received honoraria for speaking at CME meetings sponsored by Astellas, Dai-Nippon Sumitomo, Eli Lilly, GlaxoSmithKline, Janssen, Kyorin, MSD, Meiji, Mochida, Otsuka, Pfizer, Shionogi, and Tanabe-Mitsubishi. He is on the advisory board for Sekisui Chemicals and Takeda Science Foundation. He has received royalties from Igaku-Shoin, Seiwa-Shoten, Nihon Bunka Kagaku-sha and American Psychiatric Publishing. MH is on the advisory board for Sekisui Chemicals and the Ministry of Justice. He has received royalties from Shogakukan Shueisha Production, Kangokyokai Shuppan and Kongo Shuppan. NK has received honoraria for speaking at CME meetings sponsored by GlaxoSmithKline, Eizai and Pfizer. He is on the advisory board for Sekisui Chemicals and Junpukai Health Care Center. He has received royalties from Chuo-Hoki-Shuppan, Igaku-Shoin, Kyobun-do, Life Science, Maruzen, Nanko-do, Nanzan-do, and Fujitsu Software Technologies, Ltd.. MK, MS, YS, HH, MK, KA, HT, KI, MN and LCG have received honoraria for their managerial or psychotherapeutic works or for statistical advice for the current study by Sekisui Chemicals. This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. CONSORT participant flow diagram.
See this image and copyright information in PMC

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