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Cited by 487Mental Health Treatment and AccessEmployment and Welfare StudiesSchizophrenia research and treatment

Individual and societal effects of mental disorders on earnings in the United States: results from the national comorbidity survey replication

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Kessler, Ronald C., Heeringa, Steven, Lakoma, Matthew D., Petukhova, Maria, Rupp, Agnes E., Schoenbaum, Michael, Wang, Philip S., Zaslavsky, Alan M.·2008·American Journal of Psychiatry
DOI 10.1176/appi.ajp.2008.08010126PMC PMC2410028
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Abstract

OBJECTIVE: The purpose of this report was to update previous estimates of the association between mental disorders and earnings. Current estimates for 2002 are based on data from the National Comorbidity Survey Replication (NCS-R). METHOD: The NCS-R is a nationally representative survey of the U.S. household population that was administered from 2001 to 2003. Following the same basic approach as prior studies, with some modifications to improve model fitting, the authors predicted personal earnings in the 12 months before interview from information about 12-month and lifetime DSM-IV mental disorders among respondents ages 18-64, controlling for sociodemographic variables and substance use disorders. The authors used conventional demographic rate standardization methods to distinguish predictive effects of mental disorders on amount earned by persons with earnings from predictive effects on probability of having any earnings. RESULTS: A DSM-IV serious mental illness in the preceding 12 months significantly predicted reduced earnings. Other 12-month and lifetime DSM-IV/CIDI mental disorders did not. Respondents with serious mental illness had 12-month earnings averaging $16,306 less than other respondents with the same values for control variables ($26,435 among men, $9,302 among women), for a societal-level total of $193.2 billion. Of this total, 75.4% was due to reduced earnings among mentally ill persons with any earnings (79.6% men, 69.6% women). The remaining 24.6% was due to reduced probability of having any earnings. CONCLUSIONS: These results add to a growing body of evidence that mental disorders are associated with substantial societal-level impairments that should be taken into consideration when making decisions about the allocation of treatment and research resources.

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  • Among people occupying social and productive roles, major depressive disorder predicts substantial declines in role functioning, including poorer marital quality, lower work performance, and lower earnings.

    “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 [69]

  • Personal earnings and household income of people with major depressive disorder are substantially lower than those without depression, but it is unclear whether depression is primarily a cause, consequence, or both because of reciprocal causation; previous studies have not controlled for reciprocal effects, making the size of adverse effects uncertain; childhood-adolescence depression predicts

    “One of most striking aspects of the impairment associated with MDD is that the personal earnings and household income of people with MDD are substantially lower than those of people without depression.68–73 However, it is unclear whether depression is primariry a cause, consequence, or both in these associations due to the possibility of reciprocal causation between income-earnings and MDD.74”

    From The Costs of Depression (2012) · cites this paper as [69]

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Research works printed but not linked: 5

  1. [3]Harwood H, Ameen A, Denmead G, Englert E, Fountain D, Livermore G. Report to National Institute of Mental Health. Falls Church, VA: Lewin Group; 2000. The Economic Cost of Mental Illness, 1992. [Google Scholar]
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Authors
Kessler, R. C., Heeringa, S., Lakoma, M. D., Petukhova, M., Rupp, A. E., Schoenbaum, M., Wang, P. S., & Zaslavsky, A. M.
Affiliations
Harvard University (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2008-06
Volume
165
Issue
6
Pages
703-711
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.2008.08010126
PMC
PMC2410028
OpenAlex
W2115298650
Cited by
486
References
41
Citations by year
2026: 7 · 2025: 22 · 2024: 22 · 2023: 20 · 2022: 32 · 2021: 27 · 2020: 30 · 2019: 29 · 2018: 34 · 2017: 25 · 2016: 24 · 2015: 30 · 2014: 36 · 2013: 39 · 2012: 27
FWCI
37.01
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • John W. Alden Trust
  • Eli Lilly and Company
  • Pfizer
  • GlaxoSmithKline
  • Sanofi
  • National Institutes of Health
  • Pfizer Foundation
  • National Institute of Mental Health (U01-MH-60220, MH60220, HHSN271200700030C, U01MH060220)
  • National Institute on Drug Abuse
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
mental illness, earnings, severe mental illness, economic burden of mental illness, income loss, employment, substance use disorders, DSM-IV, National Comorbidity Survey Replication, gender differences
MeSH terms
Absenteeism, Adolescent, Adult, Mental Disorders, Cross-Sectional Studies, Female, Health Surveys, Humans, Income, Interview, Psychological, Male, Middle Aged, Probability, Psychotic Disorders, Sex Factors, Socioeconomic Factors, United States, Reproducibility of Results, Models, Statistical, Comorbidity

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