Depression in the workplace: Effects on short-term disability

Health Affairs

Volumn 18, Issue 5, 1999, Pages 163-171

  Kessler, Ronald C ^a   Barber, Catherine ^b   Birnbaum, Howard G ^b   Frank, Richard G ^a,c   Greenberg, Paul E ^d   Rose, Robert M ^e   Simon, Gregory E ^f   Wang, Philip ^a  

^a HARVARD MEDICAL SCHOOL   (United States)

^b Analysis Group/Economics   (United States)

^c NATIONAL BUREAU OF ECONOMIC RESEARCH   (United States)

^d Analysis Group/Economics   (United States)

^e Program on Hum/Comm Development   (United States)

^f Grp Hlth Coop Ctr Hlth Studs   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ABSENTEEISM; ADOLESCENT; ADULT; AGED; ARTICLE; COST CONTROL; ECONOMICS; FEMALE; FORECASTING; HEALTH INSURANCE; HEALTH SURVEY; HUMAN; MAJOR DEPRESSION; MALE; MENTAL PATIENT; MIDDLE AGED; OCCUPATIONAL DISEASE; STATISTICS; UNITED STATES;

ABSENTEEISM; ADOLESCENT; ADULT; AGED; COST CONTROL; DEPRESSIVE DISORDER, MAJOR; FEMALE; FORECASTING; HEALTH BENEFIT PLANS, EMPLOYEE; HEALTH SURVEYS; HUMANS; MALE; MENTALLY DISABLED PERSONS; MIDDLE AGED; OCCUPATIONAL DISEASES; UNITED STATES;

EID: 1842425217     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.18.5.163     Document Type: Article

References (23)

1. L.M. Verbrugge and D.L Patrick, "Seven Chronic Conditions: Their Impact on U.S. Adults' Activity Levels and Use of Medical Services," American Journal of Public Health 85, no. 2 (1995): 173-182; and R.C. Kessler et al., "The Effects of Chronic Medical Conditions on Work Impairment," in Caring and Doing for Others: Social Responsibility in the Domains of Family, Work, and Community, ed. A.S. Rossi (Chicago: University of Chicago Press, forthcoming).
2. L.M. Verbrugge and D.L Patrick, "Seven Chronic Conditions: Their Impact on U.S. Adults' Activity Levels and Use of Medical Services," American Journal of Public Health 85, no. 2 (1995): 173-182; and R.C. Kessler et al., "The Effects of Chronic Medical Conditions on Work Impairment," in Caring and Doing for Others: Social Responsibility in the Domains of Family, Work, and Community, ed. A.S. Rossi (Chicago: University of Chicago Press, forthcoming).
3. D.G. Blazer et al., "The Prevalence and Distribution of Major Depression in a National Community Sample: The National Comorbidity Survey," American Journal of Psychiatry 151, no. 7 (1994): 979-986; A.C. Kouzis and W.W. Eaton, "Psychopathology and the Development of Disability," Social Psychiatry and Psychiatric Epidemiology 32, no. 7 (1997): 379-386; and R.C. Kessler et al., "Past Year Use of Outpatient Services for Psychiatric Problems in the National Comorbidity Survey," American Journal of Psychiatry 156, no. 1 (1999): 115-123.
4. D.G. Blazer et al., "The Prevalence and Distribution of Major Depression in a National Community Sample: The National Comorbidity Survey," American Journal of Psychiatry 151, no. 7 (1994): 979-986; A.C. Kouzis and W.W. Eaton, "Psychopathology and the Development of Disability," Social Psychiatry and Psychiatric Epidemiology 32, no. 7 (1997): 379-386; and R.C. Kessler et al., "Past Year Use of Outpatient Services for Psychiatric Problems in the National Comorbidity Survey," American Journal of Psychiatry 156, no. 1 (1999): 115-123.
5. D.G. Blazer et al., "The Prevalence and Distribution of Major Depression in a National Community Sample: The National Comorbidity Survey," American Journal of Psychiatry 151, no. 7 (1994): 979-986; A.C. Kouzis and W.W. Eaton, "Psychopathology and the Development of Disability," Social Psychiatry and Psychiatric Epidemiology 32, no. 7 (1997): 379-386; and R.C. Kessler et al., "Past Year Use of Outpatient Services for Psychiatric Problems in the National Comorbidity Survey," American Journal of Psychiatry 156, no. 1 (1999): 115-123.
6. See, for example, J.L. Coulehan et al., "Treating Depressed Primary Care Patients Improves Their Physical, Mental, and Social Functioning," Archives of Internal Medicine 157, no. 10 (1997): 1113-1120; J. Mintz et al., "Treatments of Depression and the Functional Capacity to Work," Archives of General Psychiatry 49, no. 10 (1992): 761-768; and L. Mynors-Wallis et al., "Randomised Controlled Trial Comparing Problem Solving Treatment with Amitriptyline and Placebo for Major Depression in Primary Care," British Medical Journal 310, no. 6977 (1995): 441-445.
7. See, for example, J.L. Coulehan et al., "Treating Depressed Primary Care Patients Improves Their Physical, Mental, and Social Functioning," Archives of Internal Medicine 157, no. 10 (1997): 1113-1120; J. Mintz et al., "Treatments of Depression and the Functional Capacity to Work," Archives of General Psychiatry 49, no. 10 (1992): 761-768; and L. Mynors-Wallis et al., "Randomised Controlled Trial Comparing Problem Solving Treatment with Amitriptyline and Placebo for Major Depression in Primary Care," British Medical Journal 310, no. 6977 (1995): 441-445.
8. See, for example, J.L. Coulehan et al., "Treating Depressed Primary Care Patients Improves Their Physical, Mental, and Social Functioning," Archives of Internal Medicine 157, no. 10 (1997): 1113-1120; J. Mintz et al., "Treatments of Depression and the Functional Capacity to Work," Archives of General Psychiatry 49, no. 10 (1992): 761-768; and L. Mynors-Wallis et al., "Randomised Controlled Trial Comparing Problem Solving Treatment with Amitriptyline and Placebo for Major Depression in Primary Care," British Medical Journal 310, no. 6977 (1995): 441-445.
9. R.C. Kessler et al, "Lifetime and Twelve-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States: Results from the National Comorbidity Survey," Archives of General Psychiatry 51, no. 1 (1994): 8-19. More details on the statistical analysis are available on request from Ronald Kessler, Department of Health Care Policy, Harvard Medical School, Suite 215,180 Long-wood Avenue, Boston, MA 02115.
10. H.U. Wittchen, "Reliability and Validity Studies of the WHO Composite International Diagnostic Interview (CIDI): A Critical Review," Journal of Psychiatrie Research 28, no. 1 (1994): 57-84; and R.C. Kessler et al, "The World Health Organization Composite International Diagnostic Interview Short Form (CIDI-SF)," International Journal of Methods in Psychiatric Research 7, no. 4 (1998): 171-185.
11. H.U. Wittchen, "Reliability and Validity Studies of the WHO Composite International Diagnostic Interview (CIDI): A Critical Review," Journal of Psychiatrie Research 28, no. 1 (1994): 57-84; and R.C. Kessler et al, "The World Health Organization Composite International Diagnostic Interview Short Form (CIDI-SF)," International Journal of Methods in Psychiatric Research 7, no. 4 (1998): 171-185.
12. D.A. Revecki et al., "The Accuracy of Self-Reported Disability Days," Medical Care 32, no. 4 (1994): 401-404.
13. The instrumental-variables method attempts to circumvent the problem of reciprocal causation by identifying some predictor variables that can be assumed a priori to have direct effects on the causal variable of interest (in this case, worker depression) but not to have effects on the outcome of interest (in this case, short-term work disability) other than through the causal variable. The coefficient estimates are highly sensitive to violation of this assumption. As a result, we do not emphasize the estimates based on this method here. See J.D. Angrist, G.W. Imbens, and D.B. Rubin, "Identification of Causal Effects using Instrumental Variables," Journal of the American Statistical Association 91, no. 434 (1996): 444-455. The instruments we used were respondents' reports about whether their biological mother suffered from depression when the respondent was growing up, whether their mother was hospitalized for depression, whether their mother ever attempted suicide, and comparable measures for their biological father.
14. As noted earlier, MIDUS used a screening scale rather than a full diagnostic interview to assess major depression. The MIDUS prevalence estimate includes only definite cases. This is why the MIDUS estimate is so much lower than the NCS estimate.
15. Although the results of a linear-additive specification are reported here, we also estimated equations that included nonlinear effects of depression symptom severity and interactions between thirty-day major depression and symptom severity. However, none of these effects was either statistically or substantively significant in either survey.
16. J.R. Lave et al., "Cost-Effectiveness of Treatments for Major Depression in Primary Care Practice," Archives of General Psychiatry 55, no. 7 (1998): 645-651.
17. M.V. Pauly, Health Benefits at Work An Economic and Political Analysis of EmploymentBased Health Insurance (Ann Arbor, Mich.: University of Michigan Press, 1998).
18. D.J. Conti and W.N. Burton, "The Economic Impact of Depression in a Workplace," Journal of Occupational Mcdicine 36, no. 9 (1994): 983-988; and D.J. Conti and W.N. Burton, "Behavior Health Disability Management," in The Employee Assistance Handbook, ed. J.M. Oher (New York: Wiley and Sons, forthcoming).
19. D.J. Conti and W.N. Burton, "The Economic Impact of Depression in a Workplace," Journal of Occupational Mcdicine 36, no. 9 (1994): 983-988; and D.J. Conti and W.N. Burton, "Behavior Health Disability Management," in The Employee Assistance Handbook, ed. J.M. Oher (New York: Wiley and Sons, forthcoming).
20. Kessler et al., "The Effects of Chronic Medical Conditions on Work Impairment;" W. Goldman, J. McCulloch, and R. Sturm, "Costs and Use of Mental Health Services before and after Managed Care," Health Affairs (March/April 1998): 40-52; and D. Salkever, "Psychiatric Disability in the Workplace: Findings from Predictors and Descriptors of Psychiatric Disability Incidence Costs, Duration, and Return to Work Study" (Unpublished report, Johns Hopkins University of Hygiene and Public Health, 1999).
21. Kessler et al., "The Effects of Chronic Medical Conditions on Work Impairment;" W. Goldman, J. McCulloch, and R. Sturm, "Costs and Use of Mental Health Services before and after Managed Care," Health Affairs (March/April 1998): 40-52; and D. Salkever, "Psychiatric Disability in the Workplace: Findings from Predictors and Descriptors of Psychiatric Disability Incidence Costs, Duration, and Return to Work Study" (Unpublished report, Johns Hopkins University of Hygiene and Public Health, 1999).
22. Kessler et al., "The Effects of Chronic Medical Conditions on Work Impairment;" W. Goldman, J. McCulloch, and R. Sturm, "Costs and Use of Mental Health Services before and after Managed Care," Health Affairs (March/April 1998): 40-52; and D. Salkever, "Psychiatric Disability in the Workplace: Findings from Predictors and Descriptors of Psychiatric Disability Incidence Costs, Duration, and Return to Work Study" (Unpublished report, Johns Hopkins University of Hygiene and Public Health, 1999).
23. A. Morgado et al., "Depressed Subjects Unwittingly Over-Report Poor Social Adjustment Which They Reappraise When Recovered," Journal of Nervous and Mental Disease 179, no. 10 (1991): 614-619.