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Individual and Societal Effects of Mental Disorders on Earnings in the United States: Results From the National Comorbidity Survey Replication
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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 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]
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“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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Metadata
- 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)
- Venue
- American Journal of Psychiatry
- Published
- 2008-06
- Volume
- 165
- Issue
- 6
- Pages
- 703-711
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- 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
- green
- www.ncbi.nlm.nih.gov
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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