Severity of Depression and Magnitude of Productivity Loss

Abstract

PURPOSE Depression is associated with lowered work functioning, including absences, impaired productivity, and decreased job retention. Few studies have examined depression symptoms across a continuum of severity in relationship to the magnitude of work impairment in a large and heterogeneous patient population, however. We assessed the relationship between depression symptom severity and productivity loss among patients initiating treatment for depression. METHODS Data were obtained from patients participating in the DIAMOND (Depression Improvement Across Minnesota: Offering a New Direction) initiative, a statewide quality improvement collaborative to provide enhanced depression care. Patients newly started on antidepressants were surveyed with the Patient Health Questionnaire 9-item screen (PHQ-9), a measure of depression symptom severity; the Work Productivity and Activity Impairment (WPAI) questionnaire, a measure of loss in productivity; and items on health status and demographics. RESULTSWe analyzed data from the 771 patients who reported being currently employed. General linear models adjusting for demographics and health status showed a signifi cant linear, monotonic relationship between depression symptom severity and productivity loss: with every 1-point increase in PHQ-9 score, patients experienced an additional mean productivity loss of 1.65% (P <.001). Even minor levels of depression symptoms were associated with decrements in work function. Full-time vs part-time employment status and self-reported fair or poor health vs excellent, very good, or good health were also associated with a loss of productivity (P <.001 and P = .045, respectively).CONCLUSIONS This study shows a relationship between the severity of depression symptoms and work function, and suggests that even minor levels of depression are associated with a loss of productivity. Employers may fi nd it benefi cial to invest in effective treatments for depressed employees across the continuum of depression severity. Ann Fam Med 2011;9:305-311. doi:10.1370/afm.1260. INTRODUCTIOND epression is prevalent and incurs substantial indirect costs associated with reduced work functioning, including absences, impaired productivity, and even decreased job retention across a wide variety of occupations. [1][2][3][4] In addition, several studies have shown that even minor or subthreshold depression (including dysthymia) is related to poorer work performance. 5,6 Fewer studies have examined depression symptoms across a continuum of severity in relationship to the magnitude of work loss that includes both absences and impaired productivity. Simon et al 7 found that among outpatients treated for bipolar disorder, depression severity was strongly and consistently associated with a decreased probability of employment and more days of absence due to illness. Backenstrass et al 8 characterized a spectrum of depressive symptoms across 3 increasing levels of severity (nonspecifi c, minor, and major) and found an increasing number of days of absence due t...

Impact of binge eating disorder on functional impairment and work productivity in an adult community sample in the United States

“…In contrast, the degree of work productivity impairment in the past 7 days, as measured by the WPAI, reported in BED respondents (absenteeism: 9.59%±19.17%; presenteeism: 30.0%±31.64%) tended to be smaller in magnitude than in individuals with moderate to severe depressive symptoms (absenteeism + presenteeism: 46.9%–51.3%)18 or with moderate to severe anxiety (absenteeism: 16%±20%; presenteeism: 45%±30%) 19…”

A Stepped-Wedge Evaluation of an Initiative to Spread the Collaborative Care Model for Depression in Primary Care

“…This survey assessed the main patient outcomes at enrollment and again 6 months later, using the PHQ-9 measure of depression severity, 23,24 the Work Productivity and Activity Impairment (WPAI), 25 the World Health Organization question about health status, 26 a modified version of the Patient Assessment of Chronic Illness Care (PACIC), 27 and a question about satisfaction.…”

In This Issue: Technology and Primary Care

“…In a study of the effect of depression on work productivity, Beck et al fi nd that even minor levels of depression are associated with loss of work function. 12 A study by Azevedo-Marques and colleagues validates that the COOP/WONCA Charts, a brief pictorial functional assessment that has long been used to screen for depression, is an important tool for routine screening of mental disorders in primary care.…”