Unemployment, job retention, and productivity loss among employees with depression.

OBJECTIVE This study comprehensively assessed the work outcomes of employees with depression. METHODS We collected baseline and six-month follow-up survey data from 229 employees with depression and two employee comparison groups: a group of healthy patients for the control group (N=173) and a group with rheumatoid arthritis (N=87), a frequent source of work disability. Outcomes included new unemployment and, within the employed subgroup, job retention (versus job turnover), presenteeism (that is, diminished on-the-job performance and productivity), and absenteeism. RESULTS At the six-month follow-up, persons with depression had more new unemployment--14 percent for persons in the dysthymia group, 12 percent for persons in the major depression group, and 15 percent for persons in the group with both dysthymia and major depression, compared with 2 percent for persons in the control group and 3 percent for persons in the rheumatoid arthritis group. Among participants who were still employed, those with depression had significantly more job turnover, presenteeism, and absenteeism. CONCLUSIONS In addition to helping employees with depression obtain high-quality depression treatment, new interventions may be needed to help them to overcome the substantial job upheaval that this population experiences.

[1]  R. Hays,et al.  Similar effectiveness of paroxetine, fluoxetine, and sertraline in primary care: a randomized trial. , 2001, JAMA.

[2]  C. Sherbourne,et al.  The effects of primary care depression treatment on patients' clinical status and employment. , 2002, Health services research.

[3]  I. Wilson,et al.  Assessing the performance of a new depression screener for primary care (PC-SAD). , 2002, Journal of clinical epidemiology.

[4]  J. Fortney,et al.  A community study of depression treatment and employment earnings. , 1999, Psychiatric services.

[5]  K. Bungay,et al.  The Work Limitations Questionnaire , 2001, Medical care.

[6]  R. Spitzer,et al.  Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. , 1999, JAMA.

[7]  W. Katon,et al.  Recovery from depression, work productivity, and health care costs among primary care patients. , 2000, General hospital psychiatry.

[8]  R. Kessler,et al.  The Effects of Chronic Medical Conditions on Work Loss and Work Cutback , 2001, Journal of occupational and environmental medicine.

[9]  Tom W. Smith,et al.  The NORC General Social Survey: A User's Guide , 1991 .

[10]  E. Berndt,et al.  The Clinical and Occupational Correlates of Work Productivity Loss Among Employed Patients With Depression , 2004, Journal of occupational and environmental medicine.

[11]  David Morganstein,et al.  Cost of lost productive work time among US workers with depression. , 2003, JAMA.

[12]  M. Aronson,et al.  Screening for alcohol abuse using the CAGE questionnaire. , 1987, The American journal of medicine.

[13]  A. Stewart,et al.  Measuring Functioning and Well-Being: The Medical Outcomes Study Approach , 1992 .

[14]  Ernst R Berndt,et al.  Relationship of Employee-Reported Work Limitations to Work Productivity , 2003, Medical care.

[15]  L. Pizzi,et al.  Health-Related Workplace Productivity Measurement: General and Migraine-Specific Recommendations from the ACOEM Expert Panel , 2003, Journal of occupational and environmental medicine.

[16]  M. Nevitt,et al.  Work disability in rheumatoid arthritis: effects of disease, social, and work factors. , 1980, Annals of internal medicine.

[17]  Alan D. Lopez,et al.  The global burden of disease: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020. , 1996 .

[18]  Ronald C Kessler,et al.  The economic burden of depression in the United States: how did it change between 1990 and 2000? , 2003, The Journal of clinical psychiatry.

[19]  E. S. Rogers,et al.  Unique Issues in Assessing Work Function Among Individuals with Psychiatric Disabilities , 2001, Journal of Occupational Rehabilitation.

[20]  C. Sherbourne,et al.  Cost-effectiveness of practice-initiated quality improvement for depression: results of a randomized controlled trial. , 2001, JAMA.