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Prevalence and Effects of Mood Disorders on Work Performance in a Nationally Representative Sample of U.S. Workers
Open accessAbstract
Objective: Research on the workplace costs of mood disorders has focused largely on major depressive episodes. Bipolar disorder has been overlooked both because of the failure to distinguish between major depressive disorder and bipolar disorder and by the failure to evaluate the workplace costs of mania/hypomania. Method: The National Comorbidity Survey Replication assessed major depressive disorder and bipolar disorder with the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) and work impairment with the WHO Health and Work Performance Questionnaire. A regression analysis of major depressive disorder and bipolar disorder predicting Health and Work Performance Questionnaire scores among 3,378 workers was used to estimate the workplace costs of mood disorders. Results: A total of 1.1% of the workers met CIDI criteria for 12-month bipolar disorder (I or II), and 6.4% meet criteria for 12-month major depressive disorder. Bipolar disorder was associated with 65.5 and major depressive disorder with 27.2 lost workdays per ill worker per year. Subgroup analysis showed that the higher work loss associated with bipolar disorder than with major depressive disorder was due to more severe and persistent depressive episodes in those with bipolar disorder than in those with major depressive disorder rather than to stronger effects of mania/hypomania than depression. Conclusions: Employer interest in workplace costs of mood disorders should be broadened beyond major depressive disorder to include bipolar disorder. Effectiveness trials are needed to study the return on employer investment of coordinated programs for workplace screening and treatment of bipolar disorder and major depressive disorder.
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“Among people with specific social and productive roles, MDD is found to predict significant decrements in role functioning (e.g., low marital quality, low work performance, low earnings).”
From The Costs of Depression (2012) · cites this paper as [64]
In the citing paper
“All these studies found that MDE and MDD significantly predict overall lost work performance. Several studies attempted to estimate the annual salary-equivalent human capital value of these losses. These estimates were in the range $30.1 billion66 to $51.5 billion.64”
From The Costs of Depression (2012) · cites this paper as [64]
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“Impaired cognition is likely associated with difficulties in everyday tasks contributing to the high degree of psychosocial and functional impairments [6–8], reduced productivity [9], and disability associated with MDD [10, 11].”
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“Recently, there has been growing interest in the management of mood disorders as critical factors directly related to economic and social burden [3-5].”
Zhang, W.-R., Pandurangi, A. K., & Peace, K. E. (2007) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2007.894832 · Cited by 69
“ACCORDING to a report by the National Institute of Mental Health (NIMH) [9], around 20 million children and adults are affected by major depressive and bipolar disorders; according to a recent report [5], bipolar disorder and major depression are two of the leading causes of lost productivity in the United States.”
BackgroundFranche, R., Carnide, N., Hogg‐Johnson, S., Côté, P., Breslin, F. C., Bültmann, U., Severin, C. N., & Krause, N. (2009) · The Canadian Journal of Psychiatry · doi:10.1177/070674370905400806 · Cited by 69
“6%).(8,12) However, studies conducted with injured workers have been limited by their cross-sectional design.”
BackgroundAltered self-report of empathic responding in patients with bipolar disorder
Cusi, A., MacQueen, G. M., & McKinnon, M. C. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2009.07.009 · Cited by 66
“Peoplewith bipolar disorder (BD) experience significant disruptions in social functioning, which may negatively impact the quality of life of patients, family members and other supports (e.g., Begley et al., 2001; Lepine, 2001; Kessler et al., 2006).”
BackgroundImpact of a Work-Focused Intervention on the Productivity and Symptoms of Employees With Depression
Lerner, D., Adler, D., Hermann, R. C., Chang, H., Ludman, E. J., Greenhill, A., Perch, K., McPeck, W. C., & Rogers, W. H. (2012) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0b013e31824409d8 · Cited by 68
Tsuchiya, M., Kawakami, N., Ono, Y., Nakane, Y., Nakamura, Y., Fukao, A., Tachimori, H., Iwata, N., Uda, H., Nakane, H., et al. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.10.014 · Cited by 68
Moretti, M., Freitas, A. E., Budni, J., Fernandes, S. C. P., Balen, G. O., & Rodrigues, A. L. S. (2011) · Behavioural Brain Research · doi:10.1016/j.bbr.2011.07.024 · Cited by 68
Ellard, K. K., Bernstein, E. E., Hearing, C. M., Baek, J. H., Sylvia, L. G., Nierenberg, A. A., Barlow, D. H., & Deckersbach, T. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.05.011 · Cited by 75
“Chronic emotion dysregulation can permeate every domain of functioning for individuals struggling with BD, and is linked to impulsive, risky or self-destructive behaviors, interpersonal problems, disruptions in work productivity, and even suicidality (Kessler et al., 2006; Muhtadie, Johnson, Carver, Gotlib, & Ketter,…”
BackgroundHassan, M., & Lage, M. J. (2009) · American Journal of Health-System Pharmacy · doi:10.2146/ajhp080374 · Cited by 66
Zimmerman, M. A., Galione, J. N., Chelminski, I., Young, D., Dalrymple, K. L., & Ruggero, C. J. (2010) · Bipolar Disorders · doi:10.1111/j.1399-5618.2010.00869.x · Cited by 69
Zamorski, M. A., Rusu, C., & Garber, B. G. (2014) · The Canadian Journal of Psychiatry · doi:10.1177/070674371405900605 · Cited by 67
Domino, M., Foster, E., Vitiello, B., Kratochvil, C., Burns, B. J., Silva, S. G., Reinecke, M. A., & March, J. (2009) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1097/chi.0b013e3181a2b319 · Cited by 63
Seidel, E., Habel, U., Finkelmeyer, A. E., Hasmann, A., Dobmeier, M., & Derntl, B. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.11.006 · Cited by 66
“In bipolar disorder disruptions of social functioning have been consistently reported (e.g., Begley et al., 2001; Kessler et al., 2006).”
BackgroundYoshimasu, K., Barbaresi, W. J., Colligan, R. C., Voigt, R. G., Killian, J. M., Weaver, A. L., & Katusic, S. K. (2018) · Journal of Attention Disorders · doi:10.1177/1087054716676342 · Cited by 65
“Especially, strong associations were observed between persistent ADHD and mood disorders, anxiety disorders, and substance use disorder, also generally consistent with previous community-based findings (Hesson & Fowler, 2015; Kessler et al., 2006; Williamson & Johnston, 2015).”
BackgroundResultInfluentialChen, J., Taylor, B. V., Palmer, A. J., Kirk‐Brown, A., van Dijk, P., Simpson, S., Blizzard, L., & van der Mei, I. A. F. (2018) · Multiple Sclerosis Journal · doi:10.1177/1352458518781971 · Cited by 66
Suppes, T., Kroger, H., Pikalov, A., & Loebel, A. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.03.012 · Cited by 65
Major Depressive Disorder in the African American Population
Bailey, R. K., Patel, M., Barker, N. C., Ali, S., & Jabeen, S. (2011) · Journal of the National Medical Association · doi:10.1016/s0027-9684(15)30380-1 · Cited by 66
Greer, T. L., Sunderajan, P., Grannemann, B. D., Kurian, B. T., & Trivedi, M. H. (2014) · Depression Research and Treatment · doi:10.1155/2014/627863 · Cited by 63
“Impaired cognition is likely associated with difficulties in everyday tasks contributing to the high degree of psychosocial and functional impairments [6–8], reduced productivity [9], and disability associated withMDD [10, 11].”
BackgroundPenhaligon, N. L., Louis, W. R., & Restubog, S. L. D. (2009) · Journal of Occupational Health Psychology · doi:10.1037/a0013288 · Cited by 63
“Research suggests that it is a common psychological disorder among working populations and can have destructive consequences on work performance (e.g., Kessler et al., 2006) and interpersonal relationships (e.g., Faust, Baum, & Forehand, 1985).”
O’Donnell, L. A., Deldin, P. J., Grogan‐Kaylor, A. C., McInnis, M. G., Weintraub, J., Ryan, K. A., & Himle, J. A. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.03.015 · Cited by 63
Evidence-Based Psychotherapies for Bipolar Disorder
Novick, D. M., & Swartz, H. A. (2019) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20190004 · Cited by 68
“Bi-polar disorder is associated with a high likelihood of signi fi cant impairment across domains of living, and this is even more pronounced with early-onset bipolar disorder (14, 15).”
Kemp, D. E., Ganocy, S. J., Brecher, M., Carlson, B. X., Edwards, S., Eudicone, J. M., Evoniuk, G. E., Jansen, W. T., Leon, A. C., Minkwitz, M. C., et al. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.10.026 · Cited by 62
“Persistent depressive symptoms are associated with high rates of disability, functional and occupational deficits (Kessler et al., 2006; Judd et al., 2005; Calabrese et al., 2004; Bauer et al., 2001), greater risk for recurrence (Perlis et al., 2006), and an increased rate of suicide (Calabrese et…”
BackgroundZhang, W. R., Pandurangi, A. K., Peace, K. E., Zhang, Y. Q., & Zhao, Z. (2011) · International Journal of Data Mining and Bioinformatics · doi:10.1504/ijdmb.2011.043034 · Cited by 61
Brenninkmeijer, V., Lagerveld, S. E., Blonk, R. W. B., Schaufeli, W. B., & Meij, L. W. (2018) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-018-9760-3 · Cited by 69
“CMDs may result in declined job performance and decreased work participation, such as long-term sick leave [3, 5].”
BackgroundPsychiatric Status and Work Performance of Veterans of Operations Enduring Freedom and Iraqi Freedom
Adler, D. A., Possemato, K., Mavandadi, S., Lerner, D., Chang, H., Klaus, J. R., Tew, J. D., Barrett, D., Ingram, E. P., & Oslin, D. W. (2011) · Psychiatric Services · doi:10.1176/ps.62.1.pss6201_0039 · Cited by 137
Burden of Sickness Absence Due to Chronic Disease in the Dutch Workforce from 2007 to 2011
de Vroome, E. M. M., Uegaki, K., van der Ploeg, C. P. B., Treutlein, D., Steenbeek, R., de Weerd, M., & van den Bossche, S. N. J. (2015) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-015-9575-4 · Cited by 59
Depression in the workforce: the intermediary effect of medical comorbidity
McIntyre, R. S., Liauw, S. S. L., & Taylor, V. H. (2011) · Journal of Affective Disorders · doi:10.1016/s0165-0327(11)70006-4 · Cited by 64
Hajek, A., König, H., Buczak‐Stec, E., Blessmann, M., & Grupp, K. (2023) · Healthcare · doi:10.3390/healthcare11050705 · Cited by 68
Functional impairment in adolescents and young adults with emerging mood disorders
Scott, J. L., Scott, E. M., Hermens, D. F., Naismith, S. L., Guastella, A. J., White, D., Whitwell, B. G., Lagopoulos, J., & Hickie, I. B. (2014) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.113.134262 · Cited by 60
Intravenous Ketamine for Treatment-Resistant Major Depressive Disorder
Covvey, J. R., Crawford, A. N., & Lowe, D. (2011) · Annals of Pharmacotherapy · doi:10.1345/aph.1q371 · Cited by 58
Rumination in bipolar disorder: evidence for an unquiet mind
Ghaznavi, S., & Deckersbach, T. (2012) · Biology of Mood & Anxiety Disorders · doi:10.1186/2045-5380-2-2 · Cited by 62
“This includes impairments at work [6,7] as well as disruptions of patients’ family and social life [6].”
BackgroundWorkplace Antistigma Initiatives: A Scoping Study
Malachowski, C., & Kirsh, B. H. (2013) · Psychiatric Services · doi:10.1176/appi.ps.201200409 · Cited by 57
Munce, S. E. P., Stansfeld, S. A., Blackmore, E. R., & Stewart, D. E. (2007) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0b013e318157f0ba · Cited by 57
Seelig, M. D., & Katon, W. J. (2008) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e318169cce4 · Cited by 57
“2 lost workdays per year.(38) Consequently, the investigators concluded that the indirect costs associated with depression likely totaled tens of billions of dollars per year.”
BackgroundMinichino, A., Bersani, F. S., Spagnoli, F., Corrado, A., Michele, F. D., Calò, W. K., Primavera, M., Yang, B., Bernabei, L., Macrì, F., et al. (2014) · Behavioural Neurology · doi:10.1155/2014/876521 · Cited by 57
The Use and Performance of Productivity Scales to Evaluate Presenteeism in Mood Disorders
Despiégel, N., Danchenko, N., François, C., Lensberg, B. R., & Drummond, M. (2012) · Value in Health · doi:10.1016/j.jval.2012.08.2206 · Cited by 56
“Although the cost of presenteeism is not routinely estimated in economic evaluations, it is estimated to account for 54% to 82% of the total lost productivity in employees with mood disorders, as observed in US workers by using the World Health Organization Health and Work Performance Questionnaire (HPQ) or the Work a…”
BackgroundMethodInfluentialKim, I., Kim, H., Lim, S., Lee, M.-R., Bahk, J., June, K. J., Kim, S., & Chang, W. J. (2013) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.3356 · Cited by 56
“Depression could deteriorate industrial productivity and reduce cost effectiveness (6, 7).”
BackgroundIs it depression or is it bipolar depression?
Rolin, D. G., Whelan, J., & Montano, C. B. (2020) · Journal of the American Association of Nurse Practitioners · doi:10.1097/jxx.0000000000000499 · Cited by 58
Präsentismus Ein Review zum Stand der Forschung
Steinke, M., & Badura, B. (2011) · Cited by 55
Overview of Descriptive Epidemiology of Mental Disorders
Kessler, R. C. (2012) · Handbooks of sociology and social research · doi:10.1007/978-94-007-4276-5_9 · Cited by 56
Self-citationCocker, F., Martin, A. J., Scott, J. L., Venn, A., Otáhal, P., & Sanderson, K. A. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.07.028 · Cited by 56
“It was designed to provide updated lifetime prevalence estimates of affective, anxiety, and substance abuse disorders within the Australian population, using the Composite International Diagnostic Interview (3.0) (Kessler et al., 2006).”
Influential
Metadata
- Authors
- Kessler, R. C., Akiskal, H. S., Ames, M., Birnbaum, H., Greenberg, P., .A, R. M., Jin, R., Merikangas, K. R., Simon, G. E., & Wang, P. S.
- Affiliations
- Harvard University (US)
- Venue
- American Journal of Psychiatry
- Published
- 2006-09
- Volume
- 163
- Issue
- 9
- Pages
- 1561-1568
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC1924724
- OpenAlex
- W2120839478
- Cited by
- 868
- References
- 47
- Citations by year
- 2026: 13 · 2025: 16 · 2024: 25 · 2023: 29 · 2022: 20 · 2021: 34 · 2020: 38 · 2019: 56 · 2018: 50 · 2017: 53 · 2016: 60 · 2015: 59 · 2014: 52 · 2013: 64 · 2012: 60
- FWCI
- 27.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- John D. and Catherine T. MacArthur Foundation (R01 DA016558)
- John W. Alden Trust
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- World Health Organization
- Harvard University
- Michigan State University
- Johns Hopkins University
- University of Pittsburgh
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04)
- Substance Abuse and Mental Health Services Administration
- College of Engineering, Michigan State University
- Pfizer Foundation (R01‐MH069864, R01-DA016558)
- Pan American Health Organization
- National Institute of Mental Health (R13-MH-066849, U01-MH-60220, MH60220, U13MH066849, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (K05DA015799, R01DA016558)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- mood disorders, bipolar disorder, major depressive disorder, employee performance, work impairment, lost workdays, mania, hypomania, prevalence
- MeSH terms
- Absenteeism, Adolescent, Adult, Bipolar Disorder, Costs and Cost Analysis, Major Depressive Disorder, Depressive Disorder, Major, Efficiency, Female, Humans, Male, Middle Aged, Occupations, Psychiatric Status Rating Scales, Surveys and Questionnaires, Task Performance and Analysis, United States, Work, Comorbidity, Prevalence, Workplace, Mood Disorders
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