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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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BackgroundInfluentialSelf-citationCounseling Strategies for Empowering People Living in Poverty: The I‐CARE Model
Foss-Kelly, L. L., Generali, M. M., & Kress, V. E. W. (2017) · Journal of Multicultural Counseling and Development · doi:10.1002/jmcd.12074 · Cited by 35
Stange, J. P., MacNamara, A., Barnas, O. E., Kennedy, A. E., Hajcak, G., Phan, K. L., & Klumpp, H. (2016) · Biological Psychology · doi:10.1016/j.biopsycho.2016.10.009 · Cited by 36
Uribe, J. M., Pinto, D. M., Vecino-Ortiz, A. I., Gómez–Restrepo, C., & Rondón, M. (2017) · Value in Health Regional Issues · doi:10.1016/j.vhri.2017.03.001 · Cited by 40
“H stands for total hours of work lost due to absenteeism and presenteeism per month estimated in this study, S represents the mean value of labor earnings per hour [23], and P introduces to the equation the average number of days per year with depression [10].”
BackgroundMethodDawkins, S., Martin, A. J., Kilpatrick, M., & Scott, J. L. (2018) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001360 · Cited by 37
The Association Between Mental Disorders and Productivity in Treated and Untreated Employees
Hilton, M. F., Scuffham, P., Sheridan, J. S., Cleary, C. M., Vecchio, N., & Whiteford, H. (2009) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e3181b2ea30 · Cited by 40
Black and Blue: Depression and African American Men
Plowden, K. O., Adams, L. T., & Wiley, D. (2016) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2016.04.007 · Cited by 43
An effort to assess the relation between productivity loss costs and presenteeism at work
Vänni, K. J., Neupane, S., & Nygård, C. (2016) · International Journal of Occupational Safety and Ergonomics · doi:10.1080/10803548.2016.1197578 · Cited by 42
Influence of Comorbid Mental Disorders on Time to Seeking Treatment for Major Depressive Disorder
Olfson, M., Liu, S.-M., Grant, B. F., & Blanco, C. (2011) · Medical Care · doi:10.1097/mlr.0b013e318241eb5e · Cited by 34
Job Dissatisfaction Mediated the Associations Between Work Stress and Mental Health Problems
Qiu, D., Li, R., Li, Y., He, J., Ouyang, F., Luo, D., & Xiao, S. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.711263 · Cited by 34
Gildengers, A. G., Mulsant, B. H., Jurdi, R. K. A., Beyer, J. L., Greenberg, R. L., Gyulai, L., Moberg, P. J., Sajatovic, M., Have, T. T., Young, R. C., et al. (2010) · Bipolar Disorders · doi:10.1111/j.1399-5618.2010.00877.x · Cited by 34
Sarris, J. J., Kavanagh, D. J., Deed, G., & Bone, K. M. (2008) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.994 · Cited by 34
“Recovery is associated with lower health-care costs, fewer days missed from work and greater productivity (Kessler et al., 2006).”
BackgroundMizoue, T., Kochi, T., Akter, S., Eguchi, M., Kurotani, K., Tsuruoka, H., Kuwahara, K., Ito, R., Kabe, I., & Nanri, A. (2015) · Journal of Nutrition · doi:10.3945/jn.114.204115 · Cited by 34
“Thus, depression has been linked to substantial losses in work performance (3).”
Turney, K. (2012) · PLoS ONE · doi:10.1371/journal.pone.0045709 · Cited by 34
“Consistent with previous research, employment and relationship status are among the sociodemographic characteristics most robustly associated with both stability and change maternal depression [1,24,33–37].”
MethodResultStange, J. P., Kleiman, E. M., Sylvia, L. G., Magalhães, P. V. D. S., Berk, M., Nierenberg, A. A., & Deckersbach, T. (2016) · Depression and Anxiety · doi:10.1002/da.22464 · Cited by 36
Economic Evaluation of Mental Health Interventions: A Guide to Costing Approaches
Shearer, J., McCrone, P., & Romeo, R. (2016) · PharmacoEconomics · doi:10.1007/s40273-016-0390-3 · Cited by 34
“Presenteeism is particularly relevant in depression, accounting for 50–80 % of lost productivity [56, 57].”
Premature Mortality Among People with Mental Illness: Advocacy in Academic Psychiatry
Roberts, L. W., Louie, A. K., Guerrero, A. P. S., Balon, R., Beresin, E. V., Brenner, A. M., & Coverdale, J. (2017) · Academic Psychiatry · doi:10.1007/s40596-017-0738-9 · Cited by 35
“Less severe yet still chronic mental illnesses contribute to absenteeism and loss of employment [33].”
BackgroundPerugi, G., Pallucchini, A., Rizzato, S., Pinzone, V., & Rossi, P. D. (2019) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2019.1618270 · Cited by 35
Shinohara, S., Nakamura, M., Omiya, Y., Higuchi, M., Hagiwara, N., Mitsuyoshi, S., Toda, H., Saito, T., Tanichi, M., Yoshino, A., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18105435 · Cited by 33
“Mood disorders have become a major issue in several developed countries [1], and the economic loss due to treatment costs and interference with work is enormous [2].”
BackgroundSelf-reported cognitive problems predict employment trajectory in patients with bipolar I disorder
Gilbert, A. M., Olino, T. M., Houck, P. R., Fagiolini, A. M., Kupfer, D. J., & Frank, E. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.11.012 · Cited by 32
“Related research has found that depressed mood state accounts for a larger number of lost work days per ill worker annually among patients with bipolar versus unipolar depression (Kessler et al., 2006).”
BackgroundRascati, K. L., Richards, K. M., Ott, C. A., Goddard, A. W., Stafkey-Mailey, D., Alvir, J. M., Sanders, K. N., & Mychaskiw, M. A. (2011) · Psychiatric Services · doi:10.1176/ps.62.9.pss6209_1032 · Cited by 34
Work Functioning Measurement: Tools for Occupational Mental Health Research
Nieuwenhuijsen, K., Franche, R., & van Dijk, F. J. H. (2010) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e3181ec7cd3 · Cited by 36
Hall, W., Ruiz Rosado, B., & Chapman, M. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8070949 · Cited by 32
Personalized Medicine Using Neuroimmunological Biomarkers in Depressive Disorders
Chi, S., & Lee, M. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11020114 · Cited by 32
“Reduced workplace productivity is another outcome of depression, leading to an estimated loss of $36.6 billion per year in the United States [2].”
BackgroundInfluentialRapid antidepressant effects: moving right along
Martinowich, K., Jimenez, D. V., Zarate, C. A., & Manji, H. K. (2013) · Molecular Psychiatry · doi:10.1038/mp.2013.55 · Cited by 34
STAR*D: A Tale and Trail of Bias
Pigott, H. E. (2011) · Ethical Human Psychology and Psychiatry · doi:10.1891/1559-4343.13.1.6 · Cited by 33
Arvilommi, P., Suominen, K. H., Mantere, O., Valtonen, H., Leppämäki, S., & Isometsä, E. T. (2015) · Bipolar Disorders · doi:10.1111/bdi.12349 · Cited by 32
Pereira, M. J., Johnston, V., Straker, L. M., Sjøgaard, G., Melloh, M., O’Leary, S. P., & Comans, T. A. (2017) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001043 · Cited by 32
Mühlbauer, E., Bauer, M., Ebner‐Priemer, U., Ritter, P. S., Hill, H., Beier, F., Kleindienst, N., & Severus, E. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1929-y · Cited by 36
“Necessary reductions of working hours, higher absenteeism or premature pension are common and cause substantial secondary economic costs [5, 6].”
BackgroundCognitive functioning and lifetime major depressive disorder in UK Biobank
de Nooij, L., Harris, M. A., Adams, M. J., Clarke, T., Shen, X., Cox, S. R., McIntosh, A. M., & Whalley, H. C. (2020) · European Psychiatry · doi:10.1192/j.eurpsy.2020.24 · Cited by 32
“Furthermore, cognitive deficits were found to mediate of decreased work performance, contributing to the overall cost attributable to MDD (25,26).”
BackgroundKato, T., Baba, K., Guo, W., Chen, Y., & Nosaka, T. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.07.104 · Cited by 32
Nutritional Impact on Metabolic Homeostasis and Brain Health
Carneiro, L., & Pellerin, L. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.767405 · Cited by 33
Indirect costs associated with nonadherence to treatment for bipolar disorder
Bagalman, E., Yu-Isenberg, K. S., Durden, E., Crivera, C., Dirani, R., & Bunn, W. B. (2010) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0b013e3181db811d · Cited by 32
Kim, J. (2008) · Journal of Preventive Medicine and Public Health · doi:10.3961/jpmph.2008.41.3.200 · Cited by 32
Shan, Y., Jia, Y., Zhong, S., Li, X., Zhao, H., Chen, J., Lu, Q., Zhang, L., Li, Z., Lai, S., et al. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.10.030 · Cited by 32
“Patients with MDD suffer great personal distress, as well as significant impairments in their daily and occupational functioning (Kessler et al., 2006).”
BackgroundPsychiatric disorders and risk for multiple adverse outcomes: a national prospective study
Blanco, C., Wall, M. M., Hoertel, N., Krueger, R. F., Liu, S.-M., Grant, B. F., & Olfson, M. (2021) · Molecular Psychiatry · doi:10.1038/s41380-019-0459-4 · Cited by 36
“Although previous studies have shown that individual psychiatric disorders are associated with a broad range of adverse outcomes [1, 7, 9], our findings demonstrate that these associations are mostly mediated by a general liability to psychopathology rather than being specific to any single disorder.”
Result
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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