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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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“Depression is a significant health issue for many Americans, ranking near the top of all worksite issues resulting in referrals to Employee Assistance Programs (EAPs) with prevalence rates in the working population of more than 6% (Kessler et al., 2006).”
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“Prior studies have reported similar findings in the Mexican population living in the US (Kessler et al. 2006).”
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“5 billion annually in the United States due to lower work performance and absences (Kessler et al., 2006; Stewart, Ricci, Chee, Hahn, & Morganstein, 2003).”
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“All mood disorders could have a negative impact on quality of life and functioning and are concomitant with psychiatric and medical morbidity and mortality (9-12), and these features could lead to burnout in families and are a heavy burden on the society (11-13).”
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“On the whole, A-ADHD patients show a four to nine times greater prevalence of co-existent mental illnesses [9] and are four times more prone to having any mood disorder, when compared with the remaining adult population [10].”
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“The impact of mental health and substance abuse problems in the workplace is well-recognized, including productivity effects (Mangione et al. 1999; Kessler et al. 2006).”
Relia, S., Thompson, N. R., Mehra, R., Moul, D. E., Katzan, I. L., Foldvary‐Schaefer, N., & Walia, H. K. (2018) · Sleep And Breathing · doi:10.1007/s11325-018-1626-6 · Cited by 5
Zahl‐Olsen, R., Håland, Å. T., Gausel, N., Wampold, B. E., & Tilden, T. (2019) · Journal of Family Therapy · doi:10.1111/1467-6427.12283 · Cited by 5
Vitkauskas, M., & Mathuru, A. S. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21186525 · Cited by 5
“Failure to respond to the initial course of treatment can mean an increased risk of suicide, distress, and loss of productivity among the effected [115].”
BackgroundEnhancing Career Management Preparedness and Mental Health
Vuori, J., & Toppinen‐Tanner, S. (2015) · Aligning perspectives on health, safety and well-being · doi:10.1007/978-94-017-9798-6_13 · Cited by 5
Presenteeism: A Comparative Analysis
O'donnell, J. E. (2023) · ScholarWorks@UMassAmherst (University of Massachusetts Amherst) · doi:10.7275/867522 · Cited by 5
Schlachter, S., Adam, S. H., Baxendale, M., Gantner, M., Gralla, M., Junne, F., Martus, P., Mehler, M., Nischk, D., Pumptow, M., et al. (2024) · BMC Public Health · doi:10.1186/s12889-024-20323-0 · Cited by 4
Espinós, U., Fernández-Abascal, E. G., Bruna, M. M. O., & Lahera, G. (2021) · PLoS ONE · doi:10.1371/journal.pone.0246908 · Cited by 4
“BD can be profoundly disabling, and is associated with a substantial loss of work performance, and the consequent financial burden [10].”
BackgroundVersorgung von Menschen mit bipolar affektiven Störungen in Deutschland
Brieger, P., Bode, L., Urban, R., & Pfennig, A. (2012) · Der Nervenarzt · doi:10.1007/s00115-011-3417-1 · Cited by 4
Deckersbach, T., Stange, J. P., & Nierenberg, A. A. (2011) · CNS Spectrums · doi:10.1017/s1092852912000314 · Cited by 4
Psychosoziale und berufliche Folgen der Depression
Lang, A., Hamann, J., & Brieger, P. (2018) · Nervenheilkunde · doi:10.1055/s-0038-1670566 · Cited by 4
“Pro Jahr waren es hier 225 Millionen gefehlte Arbeitstage im Betrieb sowie eine Summe von 36,6 Milliarden US-Dollar durch Produktivitätsverluste (23).”
BackgroundPublic attitudes towards individuals with bipolar disorder in the workplace
O’Donnell, L. A., Szechy, K. A., & Loree, A. M. (2021) · Social Work in Mental Health · doi:10.1080/15332985.2021.1947438 · Cited by 4
“Estimates of unemployment among individuals with BD are as high as 65%, and up to 80% of individuals with BD experience reduced work performance and underemployment (Carlborg, Ferntoft, Thuresson, & Bodegard, 2015; Huxley & Baldessarini, 2007; Kessler et al., 2006).”
BackgroundInfluentialDoes Gratitude Prevent Negative Affectivity?
Watkins, P. C. (2013) · Springer eBooks · doi:10.1007/978-94-007-7253-3_10 · Cited by 4
Crowley, S. K. (2013) · Scholar Commons (University of South Carolina) · Cited by 4
Bipolar II Disorder in Context: A Review of Its Epidemiology, Disability and Economic Burden
Chakrabarty, T., Hadijpavlou, G., Bond, D. J., & Yatham, L. N. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108333252.006 · Cited by 4
Assessment and Treatment of Mood and Anxiety Disorders in the Workplace
Taubman, D. S., Velyvis, V., & Parikh, S. V. (2019) · Integrating psychiatry and primary care · doi:10.1007/978-3-030-04266-0_8 · Cited by 4
Gaum, P. M., Brey, F., Kraus, T., & Lang, J. (2019) · Journal of Occupational Medicine and Toxicology · doi:10.1186/s12995-019-0246-9 · Cited by 4
Analyzing the Effects of Memory Biases and Mood Disorders on Social Performance
Sreenivas, N. K., & Rao, S. (2020) · Adaptive Agents and Multi-Agents Systems · doi:10.1038/s41598-020-77715-6 · Cited by 4
Long-Term Adaptive Changes Induced by Antidepressants: From Conventional to Novel Therapies
Mnie‐Filali, O., Abrial, E., Lambás‐Señas, L., & Haddjeri, N. (2013) · InTech eBooks · doi:10.5772/54553 · Cited by 5
Adherence according to Mary Poppins: strategies to make the medicine go down.
Hardeman, S., & Narasimhan, M. (2010) · Perspectives in psychiatric care · doi:10.1111/j.1744-6163.2009.00233.x · Cited by 5
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“depressive disorder (MDD) is a dangerous and heterogeneous disease that has main harmful influences on public health (3, 4).”
BackgroundLos costos ocultos del presentismo laboral en las empresas manufactureras de Lima: 2012
Loza, D. H. V. (2016) · Quipukamayoc · doi:10.15381/quipu.v23i43.11607 · Cited by 4
“(Kessler et al, 2006a; Kessler et al, 2006b).”
Warren, P. A. (2010) · Springer eBooks · doi:10.1007/978-0-387-09814-2 · Cited by 4
Is Food Insecurity Associated with Depressive Symptoms in South Korea?
Kim, Y., Park, A., & Huang, J. X. (2016) · Asian Social Work and Policy Review · doi:10.1111/aswp.12111 · Cited by 4
Potential Use of Stem Cells in Mood Disorders
Colpo, G. D., Stertz, L., Diniz, B. S., & Teixeira, A. L. (2018) · Advances in experimental medicine and biology · doi:10.1007/5584_2018_250 · Cited by 4
Cognitive Deficits in Major Depression
Coles, A. S., Lee, Y. L., Subramaniapillai, M., & McIntyre, R. S. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-58131-8.00004-5 · Cited by 4
Functional brain alterations in anxious depression: Insights from whole-brain fMRI and meta-analysis
Huang, H., Guo, Z., Yang, X., & Qin, L. (2026) · Dialogues in Clinical Neuroscience · doi:10.1080/19585969.2026.2612918 · Cited by 3
“Some patients exhibit noticeable anxiety and agitation, leading to cognitive dysfunction, hallucinations, delusions and more (Kendler et al. 1995; Kessler et al. 2006; Nemeroff and Goldschmidt-clermont 2012). in 2017, depression affected 322 million people world-wide, approximately 4.3% of the…”
InfluentialZambrano, J., Luarte, A., Contreras, J., Perez, J. P., Yantén-Fuentes, L., Prieto, M. L., Lazcano, P., Wyneken, Ú., & Perez, C. A. (2026) · Scientific Reports · doi:10.1038/s41598-026-47476-9 · Cited by 3
Yan, S., Li, X., & Yan, T. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.990941 · Cited by 3
“, 1997; Lihua, 2017) and depression (Kessler et al., 2006) on labor productivity or wage rate.”
BackgroundMatsumoto, Y., Sakurai, H., Aoki, Y., Takaesu, Y., Okajima, I., Tachimori, H., Murao, M., Maruki, T., Tsuboi, T., & Watanabe, K. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1321611 · Cited by 3
A Retrospective Cross-Sectional Analysis of the Humanistic and Economic Burden of Bipolar I Disorder
Culpepper, L., Martin, A., Harrington, A., Wade, S. W., & Parikh, M. (2024) · Clinical Therapeutics · doi:10.1016/j.clinthera.2024.08.003 · Cited by 6
Hardi, N., Natália, N., & Theresia, F. (2024) · Cermin Dunia Kedokteran · doi:10.55175/cdk.v51i12.1260 · Cited by 3
Detección precoz de episodios de hipomanía en pacientes con trastorno afectivo
García-Castillo, I., Fernández-Mayo, L., Serrano-Drozdowskyj, E., Carmona, R., Martín-Calvo, M. J., Ovejero, S., Millán, I., López, F. J. G., & Baca‐García, E. (2012) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2011.12.002 · Cited by 3
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Rathbun‐Grubb, S. (2019) · The International Journal of Information Diversity & Inclusion (IJIDI) · doi:10.33137/ijidi.v3i4.33011 · Cited by 3
“Kessler et al. (2006) estimate that 5% of the general population has a disorder on the bipolar spectrum.”
BackgroundInfluential
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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