No one segment of the workforce has a corner on depression. But some socio-economic groups seem to have an edge when it comes to being successfully treated for the malady.  A recent study by Lydia Falconnier, assistant professor at the University of Illinois at Chicago's Jane Addams College of Social Work, finds that depression treatments are less effective for working-class patients than for their middle-class counterparts when it comes to their ability to perform on the job.

"I don't want to say these treatments aren't applicable," Falconnier says. "But there are other issues for working class and poor individuals struggling with depression that middle-class workers don't have."People who are on the lower strata of society tend to have more "stressors" than those in the middle or upper tiers, she says.

Falconnier studied 239 patients who had major depressive disorders in an effort to identify work outcomes for different social classes. Data was obtained from the National Institute of Mental Health Treatment of Depression Collaborative Research Program.

The study is one of the first to document the relationship between social class and work-functioning outcomes in depression trials. While Falconnier admits more research is needed, she believes there are some implications for employers. At the top of her list is the need for companies to make sure their employee-assistance-program clinicians are trained to work with low-income employees.

"They need to understand the life experiences of these individuals in order to adapt their treatments," Falconnier says. Because most therapists are middle class, she says, "they don't fully understand the lives of the working class."

Employers also might want to put a greater focus on the economic stressors that low-income individuals face, the research suggests. The findings speak to the importance of addressing factors that are more common to those in a lower social class and could lead to a lower level of satisfaction at work, such as the lack of transportation or the availability and affordability of childcare.

Alan Alexson, a psychiatrist who is the CEO and medical director of InterCare Psychiatric Services in Pittsburgh, isn't surprised by the findings, especially when one considers that the level of education often helps to determine social status.

"People from families that are high-school educated or less tend to have certain views of illnesses," he says. "Often, they talk about physical symptoms rather than depression. People who are college educated or come from families that are college educated, meanwhile, will [be more] sophisticated when it come to [mental-health issues]."

Alexson notes that people with higher levels of education are more willing to participate in psychotherapy and are more accepting of medications.

The level of social support could be another contributor.

"People in middle and upper [tiers] are able to respond to treatments better than those in the lower socio-economic situation because they tend to have more social supports," Alexson says.

Because of that, he says, different types of treatments might be needed.

What's Alexson's prescription?

First, employers need to make sure they're getting their money's worth out of the EAPs.

"Just as companies track other figures, such as cost of sales and cost of different materials, they need to be looking at what they're getting from the EAPs," he says.

Often, Alexson says, companies under-utilize their EAPs and don't successfully connect their employees with them.

"Whatever groups of people you employ, you need to be sure you know what the penetration rate is for each group and work with your EAPs so that more people are utilizing their services, particularly for stress reduction," he says.

Alexson also believes employers need to ensure more is being done at the primary-care level. "It is more likely that sophisticated workers are going to say, 'I'm depressed; I'll go to a psychiatrist or psychologist,' " he says. "The person with less education [and perhaps on the lower end of the social strata] is going to say, 'I'm not sleeping well, I'm going to go to the doctor and get some sleeping pills.'"The primary-care physician needs to be able to properly diagnose the depression and prescribe the appropriate treatment," he says.