[ XXXX and professional activity: results of the NEXTEP study].

@entity1 @entity308 @entity837 @entity148 @entity717
BACKGROUND: @entity308 is one of the most common diseases. It is associated with a significant @entity717 and many studies have shown that it results in numerous sick-leaves, with substantial economic burden. However, most of the studies have been conducted in Northern Europe and the situation in France remains unknown. OBJECTIVES: To describe the management of @entity308 @entity1 and assess the impact of treatment on professional activity and sick-leave. METHODS: An epidemiological observational longitudinal study (NEXTEP) performed by TNS Healthcare in private practice psychiatrists. RESULTS: Data of 2516 @entity1 included by 771 psychiatrists were analyzed. @entity1 aged 20 to 60 years, with professional activity and presenting with @entity308 were eligible if they were prescribed an antidepressant drug for the first time by this psychiatrist on the day of consultation. @entity1 represented 65% of the cohort. Mean MADRS score at baseline was 34  7.7/60 and 47% of @entity1 had a severe @entity308 ; only 5% had mild @entity308 . Professional activity was impaired in 95% of cases. A sick-leave certificate was granted to 35% of the @entity1 at the end of the first visit (first sick-leave or renewal in 14% and 21% of cases, respectively), and 100% were prescribed a pharmacological treatment (antidepressant agent). After 2 months, MADRS scores had dramatically decreased (-21 points on average) and 50% of the @entity1 were symptom free. Most @entity1 (75%) perceived improvement in working capacity; only 13% of @entity1 received a sick-leave certificate. @entity837 was associated with a significantly greater improvement in @entity308 , along with a significantly lower number and duration of sick-leave certificates. In multivariate analysis, predictors of @entity308 improvement were decreased in @entity148 , improved in self-esteem, and @entity837 treatment. DISCUSSION: Frequency and duration of sick-leave appear lower than in other studies, notably those conducted in Scandinavian countries. However, employment laws are different, which may influence the physicians' attitudes. CONCLUSION: This study is the first that accurately describes the management of @entity308 @entity1 and the impact of treatment on professional activity and sick-leave in France. It suggests that an appropriate management of @entity308 @entity1 results in a rapid improvement of symptoms and work resumption in most cases.
