Original Paper

Community Mental Health Journal

, Volume 45, Issue 5, pp 333-340

Antidepressant Adequacy and Work Status Among Medicaid Enrollees with Disabilities: A Restriction-based, Propensity Score-adjusted Analysis

  • Eric G. SmithAffiliated withCenter for Psychopharmacologic Research and Treatment, University of Massachusetts Medical School Email author 
  • , Alexis D. HenryAffiliated withCenter for Health Policy and Research (CHPR), University of Massachusetts Medical School
  • , Jianying ZhangAffiliated withCenter for Health Policy and Research (CHPR), University of Massachusetts Medical School
  • , Fred HoovenAffiliated withCenter for Outcomes Research, University of Massachusetts Medical School
  • , Steven M. BanksAffiliated withCenter for Health Policy and Research (CHPR), University of Massachusetts Medical SchoolDepartment of Psychiatry, University of Massachusetts Medical School

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Abstract

This cross-sectional study of adult survey respondents with disability and depression (n = 199) enrolled in Massachusetts’ Medicaid program examined the association of adequately or inadequately prescribed antidepressant treatment and self-reported work status using conditional logistic regression, controlling for age, gender, race, marital status, education, receipt of SSI/SSDI, self-reported disabling condition, and health status. Confounding by severity was addressed by two methods: restriction of our sample and subsequent stratification by propensity score. Individuals receiving adequate antidepressant treatment had an increased odds of working compared to individuals receiving inadequate treatment, both in analyses in which restriction was used to limit confounding (OR = 3.45, 95% CI = 1.15–10.32, P < .03), and in analyses which combined restriction with adjustment by propensity score stratification (OR = 3.04, 95% CI = 1.01–9.62, P < .05). Among this sample of Medicaid enrollees with disability and depression, those receiving adequate antidepressant treatment were significantly more likely to report working.

Keywords

Depression Disability Employment Antidepressant treatment Restriction Propensity score