Enhancing sense of coherence via early intervention among depressed occupational health care
clients
Sammanfattning
Background: Research on interventions improving psychological adjustment has suggested that
sense of coherence (SOC) could be improved. Aims: In the present study, we measured the impact of
an intervention on the SOC among adults with first-episode depression. We also examined whether
rehabilitation, depression, occupational stressors, life situation stressors and socio-demographic
characteristics are associated with a change in the SOC. Methods: Occupational health care clients
were screened for depression using the Beck Depression Inventory (BDI) and a structured clinical
interview (the The Structured Clinical Interview for DSM-IV: SCID-I). The participating subjects were
randomized into a rehabilitation group (n = 134) and control group (n = 100) receiving treatment as
usual. The Sense of Coherence Scale (SOC-13) was used at the baseline and in a 1-year follow-up to
compare the change of the SOC between the groups. Results: The increase in the mean SOC score
was statistically significant both in the rehabilitation group (54.91 compared with 62.85, P < 0.001)
and in the control group (55.29 compared with 61.64, P < 0.001). There was no significant difference
in the mean SOC scores between the groups at the follow-up. The improved SOC was associated with
less severe depression (P = 0.003) and greater decreasing in BDI (P = 0.041) in the rehabilitation
group. Conclusions: The results suggest that both rehabilitation and conventional depression
treatment in a first episode of depression may enhance the SOC and that rehabilitation itself
enhances the SOC more effectively among those with less severe depression or those whose BDI
scores had further decreased at the 1-year follow-up.