Please select the eligibility criteria that correspond to the clinical trial below.
Title: SAFARI-Return to Work: Promoting Health and Productivity in Workers With Common Mental Disorders
Brief Summary: Evidence-based clinical treatments for common mental disorders, such as CBT and/or pharmacotherapy, have resulted in significant and sustained improvement in clinical symptoms. However, the individual-focused treatments rarely have sickness absence as a target of intervention or evaluate work-related outcomes, such as return to work. A recent review of the evidence for managing stress at work showed that individual interventions give effects on mental health measures but did not impact absenteeism at work. The purpose of this study is to examine the efficacy and cost-effectiveness of two different rehabilitation models, one based on psychotherapy and the other on workplace-interventions, when these are offered as standalone interventions and in combination for patients with adjustment, anxiety and depressive disorders.


Options:
A: Inclusion Criteria:

* A primary diagnosis of Major Depressive Disorder, single or recurrent episode, without psychotic features.
* Depressive symptoms for at least 30 days before the screening visit.
* Outpatient men and women at least 18 years of age.

Exclusion Criteria:

* Significant risk of suicide based on clinical judgment, including common suicidal thoughts and suicide having been considered as a possible solution even without specific plans or intent.
* Any unstable hepatic, renal, pulmonary, cardiovascular (including uncontrolled hypertension), ophthalmologic, neurologic, or any other medical condition that might confound the study or put the subject at greater risk during study participation.
* Current (within 12 months before baseline) psychoactive substance abuse or dependence (including alcohol), manic episode, posttraumatic stress disorder, obsessive-compulsive disorder, or a lifetime diagnosis of bipolar or psychotic disorder; b) current (within 12 months before baseline) generalized anxiety disorder, panic disorder, or social anxiety disorder; c) presence (within 12 months before baseline) of a clinically important personality disorder as assessed during the psychiatric assessments.
B: Inclusion criteria

* Age 18 years and up
* Attends a participating primary health care center in the region
* Diagnosis of mild/moderate depressive disorder (new episode)
* No change in possible antidepressant maintenance therapy during the preceding 1 month
* Provided written informed consent

Exclusion criteria

* Antidepressant medication initiated or changed during the preceding 1 month
* Patient diagnosed with major depressive disorder (BDI-II \>28)
* Patients diagnosed of severe mental psychiatric disorder (i.e. bipolar disorder, antisocial personality disorder, psychosis, substance use disorder or other serious mental disorder)
* Suicidal ideation or intentions
* Inability to speak and understand Swedish language well enough to take part in the activities required in the study.
* Cognitive impairment that makes it impossible to take part in the activities required in the study
* Does not provide written informed consent to participation in the study
C: Inclusion Criteria:

DSM-IV TR Diagnosis of Major Depression receiving medication management.

Adequate trial of 2 or more antidepressants (ATHF) for a minimum of 6 weeks (one of which at UCSF).

Hamilton Depression Rating Scale 17 score ≥ 14

Any Ethnicity

English Speaking

Male or Female

No current psychotherapy (i.e. only medication management treatment) or plan to start new psychotherapy during MBCT or HEP

Exclusion Criteria:

Bipolar Disorder, Obsessive Compulsive Disorder, Schizophrenia, Schizoaffective Disorder, Antisocial and Borderline Personality Disorders, Current Eating Disorder, Pervasive Development Delay Major Depression with Psychotic Features

Active Suicidality (per HAM-D17 \> 1 on item 3)

Meditation Practice once or more per week; yoga more than twice per week at study entry

Substance Abuse Disorder within 6 months

Cognitive Disorder with Mini Mental Status Exam score \< 25

Medical illness rated 4 on Cumulative Illness Rating Scale
D: Inclusion Criteria:

Employment grade at 50% minimum. On Sick-leva for at least 1-12 moths due to adjustment, anxiety or depressive disorders.

Exclusion Criteria:

Patients with addiction disorders, schizophrenia, psychotic disorders high suicidal risk, bipolar disorder, severe depression or generalized anxiety disorder. Patients on current psychotherapy. Patients that do not speak and write Swedish.

Answer: D