Presentation T P28
T P28 (Poster Presentation):
Association between receipt of psychotherapy and disability benefit claim closure among patients disabled due to depression
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada
- Department of Anesthesia, McMaster University, Hamilton, Canada
- Department of Medicine, Stanford University, Stanford, USA
- Department of Anaesthesia & Pain Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
- National Disability Services, Policy & Procedure department, Sun Life Financial, Toronto, Canada
- Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Mood Disorders program, St. Joseph’s Healthcare, Hamilton, Canada
Depression is one of the most frequent reasons for receiving disability benefits in North America. Psychotherapy is commonly used to manage patients with depression. Private insurers often fund psychotherapy for patients receiving disability benefits due to depression. No studies have explored the association between the provision of psychotherapy for depression and time to disability benefit claim closure.
Using administrative data from a large Canadian disability insurer, we evaluated the association between the provision of psychotherapy and short-term disability (STD) and long-term disability (LTD) claim closure by performing Cox proportional hazards regression.
We analyzed 10,508 STD and 10,338 LTD claims for depression. In our adjusted analyses, receipt of psychotherapy was associated with longer time to STD closure (hazards ratio (HR) [99% confidence interval (CI)] = 0.81 [0.68 to 0.97]) and faster LTD claim closure (1.42 [1.33 to 1.52]). In both STD and LTD, older age (0.90 [0.88 to 0.92] and 0.83 [0.80 to 0.85]), per decade), a primary diagnosis of recurrent depression versus non-recurrent major depression (0.78 [0.69 to 0.87] and 0.80 [0.72 to 0.89]), a psychological secondary diagnosis (0.90 [0.84 to 0.97] and 0.66 [0.61 to 0.71]), or a non-psychological secondary diagnosis (0.81 [0.73 to 0.90] and 0.77 [0.71 to 0.83]) versus no secondary diagnosis, and an administrative services only policy ([0.94 [0.88 to 1.00] and 0.87 [0.75 to 0.996]) or refund policy (0.86 [0.80 to 0.92] and 0.73 [0.68 to 0.78]) compared to non-refund policy claims were independently associated with longer time to disability claim closure.
We found, paradoxically, that receipt of psychotherapy was independently associated with longer time to STD claim closure and faster LTD claim closure in patients with depression. We also found multiple factors that were predictive of time to both STD and LTD claim closure. Our study has limitations, and well-designed prospective studies are needed to establish the effect of psychotherapy on disabling depression.
Tuesday September 30
12:45 - 13:45 Poster Viewing
Session: Mental disorders