- The Lam Employment Absence and Productivity Scale, or LEAPS, provides important information on how patients are functioning at work. This tool can help physicians make management decisions such as whether or not a patient should stay at work, whether work functioning improves along with symptoms, and whether changes in treatment are needed to optimize work functioning.
- The LEAPS was designed specifically for the clinical practice setting. It is a 10-item, self-rated scale that takes only 3 to 5 minutes for the patient to complete. It is simple and easy to use. Patients can complete the LEAPS in the waiting room or at home, and can score it themselves.
- The items were chosen based on the symptoms that have the most impact on work productivity and the most common productivity problems experienced by patients with depression. The LEAPS was recently validated in a sample of 234 consecutive working patients meeting DSM-IV criteria for MDD attending a mood disorders outpatient clinic (Lam et al, 2009).
- How can the LEAPS be used to guide clinical management of working patients with depression? Since the LEAPS is not a diagnostic tool, it should be used in conjunction with a symptom rating scale such as the PHQ-9 or the QIDS-SR. A key benefit of the LEAPS scale is that the total score can provide a quick measure of the degree of impairment in a patient’s occupational functioning.
- The individual productivity items can also help guide treatment decisions including whether it is appropriate and/or safe for the patient to remain at work; or whether the patient should take time off work. For example, a patient in a safety-sensitive job who endorses making more mistakes at work might benefit from workplace accommodation or a leave from work.
- The LEAPS can also help monitor changes in occupational functioning over time. By using a validated tool such as the LEAPS, clinicians can be assured they are monitoring functional outcomes in a standardized way. Furthermore, the LEAPS can serve as a useful charting tool to assess patient progress. The LEAPS total score provides a quick gauge of how the patient is functioning at work, which can save physicians time by eliminating the need to write notes describing how the patient is doing.
- Patients can fill in the LEAPS during follow-up visits (for example, at 4-week intervals or as clinically appropriate). Ideally, improvements in work functioning should parallel improvements in symptoms, however full functional recovery may take longer to achieve than symptomatic remission.
Download the LEAPS
Video about using the LEAPS
And check out MoodFx, which includes the LEAPS
- MoodFx (pronounced “Mood Effects”) is a new, free, interactive mobile web app designed to help Canadian workers with clinical depression.
- MoodFx allows its users to easily and conveniently monitor their symptoms using validated clinical questionnaires, including:
- You can explore MoodFx, and sign for free, at www.MoodFx.ca.
- MoodFx helps patients to learn about and evaluate their symptoms and allows clinicians to easily implement measurement-based care with their patients.
Lam RW, Parikh SV, Ramasubbu R, Michalak EE, Tam EM, Axler A, et al. Effects of combined pharmacotherapy and psychotherapy for improving work functioning in major depressive disorder. Br J Psychiatry 2013; 203:358-365.
This is a clinical trial where the LEAPS was used as an outcome measure.
Lam RW, Michalak EE, Yatham LN. A new clinical rating scale for work absence and productivity: validation in patients with major depressive disorder. BMC Psychiatry 2009; 9:78.
The original validation study for the LEAPS.
- Sockalingam S, et al. Employment outcomes one year after bariatric surgery: the role of patient and psychosocial factors. Obes Surg 2014 Sep 24. [Epub ahead of print].
A study using the LEAPS as an outcome measure.
- Despiegel N, et al. The use and performance of productivity scales to evaluate presenteeism in mood disorders. Value Health 2012; 15:1148-61.
A systematic review of productivity scales, including the LEAPS.
- Abma FI, et al. Evaluation of the measurement properties of self-reported health-reported work-functioning instruments among workers with common mental disorders. Scand J Work Environ Health 2012; 38:5-18.
Another systematic review of work functioning scales, including the LEAPS.
- Lam RW, Filteau MJ, Milev R. Clinical effectiveness: the importance of psychosocial functioning outcomes. J Affect Disord 2011; 132:S9-13.
This paper reviews the rationale of using functional outcome scales (like the LEAPS) for the clinical care of people with depression.