Prevalence and Change in Work-Related Impairment Among Users of a Guided Digital Intervention for Depression and Anxiety: A Retrospective Cohort Analysis

Although there is a growing body of evidence to demonstrate the efficacy and effectiveness of digital interventions for reducing psychological symptom severity, relatively few studies have examined the impact of these tools on functional impairment, including work-related impairment. Work-related impairment is a primary driver of individual and societal costs associated with depression and anxiety and is a key treatment outcome of interest. This study aimed to describe the impact of a guided digital intervention for depression, generalized anxiety, and social anxiety on user-reported work- related impairment by examining 1) the prevalence of work-related impairment, 2) the magnitude of change in work- related impairment over the course of the program, and 3) the association between symptom severity and work-related impairment. Results suggest that 25.1% of users reported that their work was very much or extremely impaired by their depression or anxiety symptoms. There was a significant association between module completion and improved work- related impairment for the Depression (β=-0.1; p<.0001), Generalized Anxiety (β=-0.1; p<.0001), and Social Anxiety (β=-0.1; p<.0001) programs. Associations between module completion and change in work-related impairment retained significance with covariate adjustment. Of the users reporting the most severe baseline impairment, 78% endorsed improved functioning at their final assessment. There was also a moderate correlation (r= 0.2-0.5, p<.05) between baseline symptom severity and work-related impairment. Digital interventions have potential to improve work-related impairment and measuring impairment in addition to symptom severity may add important clinical information allowing for a more thorough evaluation of the effectiveness of these tools.