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Depression has a far larger impact on ‘presenteeism’ or reduced productivity while at work, than on absenteeism, Yale School of Medicine researchers report in a new study published in the May issue of the American Journal of Psychiatry.
“The findings suggest that depression has a substantial and persistent association with decreased workplace productivity, an impact that may be underestimated when looking only at days missed from work,” said Benjamin Druss, M.D., lead author on the study and assistant professor of psychiatry and in the Department of Epidemiology and Public Health at Yale School of Medicine.
Druss said a second important finding is that depressed workers who report poor quality of health care are most likely to have persistent depressive symptoms and decreased work productivity.
“The findings support a growing body of literature demonstrating the impact of depression in the workplace,” said Druss. “In our study, the impact of depression on function at work was substantially higher than its association with missed days at work, suggesting that previous reports of absenteeism may represent only a small fraction of the cost of depression in the workplace.”
“The costs are greatest in depressed individuals with problems in obtaining good health care,” Druss adds. “This lends support to the notion that improving patient care can have an impact on improving not only clinical outcomes, but also workplace productivity.”
Using two longitudinal surveys given in 1993 and 1995, Druss and his team employees of three major U.S. corporations. At a two-year follow-up, the team found that employees with chronic depressive symptoms reported a twofold increase in missed workdays and a more than sevenfold greater odds of decreased workplace effectiveness, compared to those without depressive symptoms.
Among employees with depression at the start of the study, problems with health care predicted a 34 percent increase in likelihood of persistent depression, and a 66 percent increase in likelihood of problems with work productivity two years later.
To assess satisfaction with health care, respondents to the 1993 survey were asked questions addressing 13 separate domains of health care satisfaction-six domains pertaining to the provision of clinical care and seven related to plan administration. Ten to 20 percent of the sample reported dissatisfaction with each of the domains of care.
To assess workplace performance, respondents to the 1995 survey were asked whether they had missed one or more days from work because of health problems in the previous four weeks. They were also asked to rate the impact of their health on effectiveness at work, on a scale of zero (unable to accomplish anything due to health) to 100 (at best, with no health problems).
Other researchers on the study included Mark Schlesinger, associate professor in the Department of Epidemiology and Public Health at Yale and Harris Allen, of Harris Allen Associates. The study was funded with grants from the National Alliance for Research on Schizophrenia and Depression (NARSAD) and the National Institute of Mental Health (NIMH).