Community Mental Health Journal

, Volume 45, Issue 5, pp 333–340 | Cite as

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

  • Eric G. Smith
  • Alexis D. Henry
  • Jianying Zhang
  • Fred Hooven
  • Steven M. Banks
Original Paper


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.


Depression Disability Employment Antidepressant treatment Restriction Propensity score 


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Eric G. Smith
    • 1
  • Alexis D. Henry
    • 2
  • Jianying Zhang
    • 2
  • Fred Hooven
    • 3
  • Steven M. Banks
    • 2
    • 4
  1. 1.Center for Psychopharmacologic Research and TreatmentUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Center for Health Policy and Research (CHPR)University of Massachusetts Medical SchoolShrewsburyUSA
  3. 3.Center for Outcomes ResearchUniversity of Massachusetts Medical SchoolWorcesterUSA
  4. 4.Department of PsychiatryUniversity of Massachusetts Medical SchoolWorcesterUSA

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