Review: Back to Work

This is a review of an open-access paper in BMC Psychiatry ‘A New Clinical Rating Scale for Work Absence and Productivity: Validation in Patients with Major Depressive Disorder’ by Lam, Michalek and Yatham and freely available here. In the journal, this paper is described as ‘Highly Accessed’ which is a neat feature of online journals – the ability to respond to the reader’s (passive) feedback. The title is self-explanatory. The researchers wanted to create a tool to measure productivity and work absence. Such tools  apparently have not been ‘optimi(s)ed for clinical use’.

I sneaked ahead here and had a look at the clinical scale which is attached as a pdf. The question I had was ‘what would such a scale look like’. On looking at the scale it became immediately obvious that this was ‘optimised’ for depression. Essentially the questionnaire focuses on what the subject has been experiencing at work – more specifically how have depressive symptoms been influencing work. Examples include questions examining attention and irritability. It’s easy to see how these questionnaires can be adapted for different illnesses but slightly more difficult to see how they should be adapted to different work environments.

Returning to the questionnaire however, the researchers wanted to validate this so presumably it can be used in practice. The methodology starts to get quite technical although they are using standard procedures for validating questionnaires. They select subjects with major depressive disorder (DSM-IV) who are working and the selection criteria seemed quite reasonable. They administer other validated measures of  productivity in the workplace and then correlate the scores across scales to determine if the LEAPS questionnaire is assessing the construct of interest. They investigate the internal reliability of the questionnaire items using a very specific statistical approach and then examine whether or not it is possible to discriminate different severities of depression. With the exception of a few minor deviations, the researchers demonstrate internal consistency, construct validity and discrimination of different severities of depression.

However I had just a few minor points. The work absence appears to be represented by a single item – how many hours of work were missed because of the way the person was feeling. This requests the subject to provide a numerical response although this is presumably continuous data. On the other hand, for issues around productivity subjects use likert responses which essentially are discrete. There are also more of these items being assessed. So in effect, the productivity element is being investigated to a greater extent than the work absence element. I wasn’t clear on how the questionnaire was going to be disseminated. In order to use the scale, the clinician will presumably need access to the normal distribution data to interpret the results. The questionnaire itself is completed by the subject.

More research is apparently underway with this questionnaire.

Call for Authors: If you are interested in writing an article or series of articles for this blog please write to the e-mail address below. Copyright can be retained.
Index: An index of the site can be found here. The page contains links to all of the articles in the blog in chronological order.
Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.
Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period.
TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.
Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.
Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

2 thoughts on “Review: Back to Work

  1. Nitric Oxide Review

    Well I do not typically comment on blogs but I ran into yours while I was doing some work researching in Bing today so i decided I would leave a simple comment. Needless to say I have gotten a tad sidetracked after sticking around to browse a number of your articles. Keep up the excellent writing and i’m already looking forward to exploring upcoming posts. Take care!

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s