Impact of bipolar disorder on employers: Rationale for workplace interventions

Disease Management and Health Outcomes

Volumn 13, Issue 4, 2005, Pages 267-280

  Montejano, Leslie B ^a   Goetzel, Ron Z ^a,b   Ozminkowski, Ronald J ^a,b  

^a MEDSTAT GROUP   (United States)

^b Department of Obstetrics Gynecology   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTICONVULSIVE AGENT; ANTIDEPRESSANT AGENT; ARIPIPRAZOLE; CARBAMAZEPINE; GABAPENTIN; HALOPERIDOL; LAMOTRIGINE; LITHIUM; NEUROLEPTIC AGENT; OLANZAPINE; QUETIAPINE; RISPERIDONE; VALPROIC ACID; ZIPRASIDONE;

BIPOLAR DISORDER; COMORBIDITY; DIAGNOSTIC ERROR; ELECTROCONVULSIVE THERAPY; EMPLOYEE; EMPLOYER; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH EDUCATION; HEALTH INSURANCE; HUMAN; PRACTICE GUIDELINE; PRODUCTIVITY; PSYCHOSOCIAL CARE; PSYCHOTHERAPY; QUALITY OF LIFE; REVIEW; SEX DIFFERENCE; WORKPLACE;

EID: 23744474920     PISSN: 11738790     EISSN: 11738790     Source Type: Journal    
DOI: 10.2165/00115677-200513040-00005     Document Type: Review

References (121)

1. Goetzel RZ, Ozminkowski RJ, Meneades L, et al. Pharmaceuticals: cost or investment? An employer's perspective. J Occup Environ Med 2000 Apr; 42 (4): 338-51
2. Goetzel RZ, Hawkins K, Ozminkowski RJ, et al. The health and productivity cost burden of the "top 10" physical and mental health conditions affecting six large US employers in 1999. J Occup Environ Med 2003 Jan; 45 (1): 5-14
3. Goetzel RZ, Long SR, Ozminkowski RJ, et al. Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers. J Occup Environ Med 2004 Apr; 46 (4): 398-412
4. Goetzel RZ, Ozminkowski RJ. Disease management as a part of total health and productivity management. Dis Manage Health Outcomes 2000 Sep; 8 (3): 121-8
5. Lewis L. A consumer perspective concerning the diagnosis and treatment of bipolar disorder. Biol Psychiatry 2000 Sep 15; 48 (6): 442-4
6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th edition, text revision. Washington, DC: American Psychiatric Association, 2000
7. Calabrese JR, Shelton MD, Rapport DJ, et al. Current research on rapid cycling bipolar disorder and its treatment. J Affect Disord 2001 Dec; 67 (1-3): 241-55
8. Akiskal HS, Pinto O. The evolving bipolar spectrum: prototypes I, II, III, and IV. Psychiatr Clin North Am 1999 Sep; 22 (3): 517-34
9. Angst J, Gamma A, Benazzi F, et al. Diagnostic issues in bipolar disorder. Eur Neuropsychopharmacol 2003 Aug; 13 Suppl. 2: S43-50
10. Angst J, Gamma A, Benazzi F, et al. Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. J Affect Disord 2003 Jan; 73 (1-2): 133-46
11. Loranger AW, Levine PM. Age at onset of bipolar affective illness. Arch Gen Psychiatry 1978 Nov; 35 (11): 1345-8
12. Burke KC, Burke JD, Regier DA, et al. Age at onset of selected mental disorders in five community populations. Arch Gen Psychiatry 1990 Jun; 47 (6): 511-8
13. Suppes T, Leverich GS, Keck PE, et al. The Stanley Foundation Bipolar Treatment Outcome Network II: demographics and illness characteristics of the first 261 patients. J Affect Disord 2001 Dec; 67 (1-3): 45-59
14. Johnson L, Andersson-Lundman G, Aberg-Wistedt A, et al. Age of onset in affective disorder: its correlation with heredity and psychosocial factors. J Affect Disord 2000 Aug; 59 (2): 139-48
15. Kessler RC, Foster CL, Saunders WB, et al. Social consequences of psychiatric disorders: I. Educational attainment. Am J Psychiatry 1995 Jul; 152 (7): 1026-32
16. Tse SS, Walsh AE. How does work work for people with bipolar affective disorder? Occup Ther Int 2001; 8 (3): 210-25
17. Spearing M. Bipolar disorder. Bethesda (MD): National Institutes of Health, National Institute of Mental Health; 2002 Sep. NIH publication no. 02-3679
18. Perlis RH, Miyahara S, Marangell LB, et al. Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biol Psychia-try 2004 May 1; 55 (9): 875-81
19. Faraone SV, Biederman J, Wozniak J, et al. Is comorbidity with ADHD a marker for juvenile-onset mania? J Am Acad Child Adolesc Psychiatry 1997 Aug; 36 (8): 1046-55
20. Sachs GS, Baldassano CF, Truman CJ, et al. Comorbidity of attention deficit hyperactivity disorder with early- and late-onset bipolar disorder. Am J Psychi-atry 2000 Mar; 157 (3): 466-8
21. Wozniak J, Biederman J, Kiely K, et al. Mania-like symptoms suggestive of childhood-onset bipolar disorder in clinically referred children. J Am Acad Child Adolesc Psychiatry 1995 Jul; 34 (7): 867-76
22. Burt VK, Rasgon N. Special considerations in treating bipolar disorder in women. Bipolar Disord 2004 Feb; 6 (1): 2-13
23. Arnold LM. Gender differences in bipolar disorder. Psychiatr Clin North Am 2003 Sep; 26 (3): 595-620
24. Salloum IM, Thase ME. Impact of substance abuse of the course and treatment of bipolar disorder. Bipolar Disord 2000 Sep; 2 (3 Pt 2): 269-80
25. Strakowski SM, DelBello MP. The co-occurrence of bipolar and substance use disorders. Clin Psychol Rev 2000 Mar; 20 (2): 191-206
26. Dalton EJ, Cate-Carter TD, Mundo E, et al. Suicide risk in bipolar patients: the role of co-morbid substance use disorders. Bipolar Disord 2003 Feb; 5 (1): 58-61
27. Freeman MP, Freeman SA, McElroy SL. The comorbidity of bipolar and anxiety disorders: prevalence, psychobiology, and treatment issues. J Affect Disord 2002 Feb; 68 (1): 1-23
28. Judd LL, Akiskal HS, Schettler PJ, et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry 2002 Jun; 59 (6): 530-7
29. Judd LL, Akiskal HS, Schettler PJ, et al. A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Arch Gen Psychiatry 2003 Mar; 60 (3): 261-9
30. Lish JD, Dime-Meenan S, Whybrow PC, et al. The National Depressive and Manic-depressive Association (DMDA) survey of bipolar members. J Affect Disord 1994 Aug; 31 (4): 281-94
31. Calabrese JR, Hirschfeld RM, Reed M, et al. Impact of bipolar disorder on a US community sample. J Clin Psychiatry 2003 Apr; 64 (4): 425-32
32. Kusznir A, Cooke RG, Young LT. The correlates of community functioning in patients with bipolar disorder. J Affect Disord 2000 Dec; 61 (1-2): 81-5
33. Cooke RG, Robb JC, Young LT, et al. Well-being and functioning in patients with bipolar disorder assessed using the MOS 20-ITEM short form (SF-20). J Affect Disord 1996 Jul; 39 (2): 93-7
34. Arnold LM, Witzeman KA, Swank ML, et al. Health-related quality of life using the SF-36 in patients with bipolar disorder compared with patients with chronic back pain and the general population. J Affect Disord 2000 Jan-Mar; 57 (1-3): 235-9
35. Vojta C, Kinosian B, Glick H, et al. Self-reported quality of life across mood states in bipolar disorder. Compr Psychiatry 2001 May-Jun; 42 (3): 190-5
36. Atkinson M, Zibin S, Chuang H. Characterizing quality of life among patients with chronic mental illness: a critical examination of the self-report methodology. Am J Psychiatry 1997 Jan; 154 (1): 99-105
37. Russo J, Roy-Byrne P, Reeder D, et al. Longitudinal assessment of quality of life in acute psychiatric inpatients: reliability and validity. J Nerv Ment Dis 1997 Mar; 185 (3): 166-75
38. Dore G, Romans SE. Impact of bipolar affective disorder on family and partners. J Affect Disord 2001 Dec; 67 (1-3): 147-58
39. Perlick D, Clarkin JF, Sirey J, et al. Burden experiences by care-givers of persons with bipolar affective disorder. Br J Psychiatry 1999 Jul; 175 (1): 56-62
40. Perlick DA, Rosenheck RR, Clarkin JF, et al. Impact of family burden and patient symptom status on clinical outcome in bipolar affective disorder. J Nerv Ment Dis 2001 Jan; 189 (1): 31-7
41. Ghaemi SN, Sachs GS, Chiou AM, et al. Is bipolar disorder still underdiagnosed? Are antidepressants overutilized? J Affect Disord 1999 Jan-Mar; 52 (1-3): 135-44
42. Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the National Depressive and Manic-depressive Association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry 2003 Feb; 64 (2): 161-74
43. Hirschfeld RM, Calabrese JR, Weissman MM, et al. Screening for bipolar in the community. J Clin Psychiatry 2003 Jan; 64 (1): 53-9
44. Evans DL. Bipolar disorder: diagnostic challenges and treatment considerations. J Clin Psychiatry 2000; 61 Suppl. 13: 26-31
45. Ghaemi N, Sachs GS, Goodwin FK. What is to be done? Controversies in the diagnosis and treatment of manic-depressive illness. World J Biol Psychiatry 2000 Apr; 1 (2): 65-74
46. Bowden CL. Strategies to reduce misdiagnosis of bipolar disorder. Psychiatr Serv 2001 Jan; 52 (1): 51-5
47. Ghaemi SN, Stoll AL, Pope HG. Lack of insight in bipolar disorder: the acute manic episode. J Nerv Ment Dis 1995 Jul; 183 (7): 464-7
48. Stensland MD, deLay N, Ciaglia M, et al. Misdiagnosis of bipolar disorder as unipolar depression [abstract]. Value Health 2004 May/Jun; 7 (3): 283
49. Schott RL. Managers and mental health: mental illness and the workplace. Public Pers Manage 1999 Summer; 28 (2): 161-83
50. Frank E, Swartz HA, Mallinger AG, et al. Adjunctive psychotherapy for bipolar disorder: effects of changing treatment modality. J Abnorm Psychol 1999 Nov; 108 (4): 579-87
51. Malkoff-Schwartz S, Frank E, Anderson B, et al. Stressful life events and social rhythm disruption in the onset of manic depressive bipolar episodes: a preliminary investigation. Arch Gen Psychiatry 1998 Aug; 55 (8): 702-7
52. Goetzel RZ, Ozminkowski RJ, Sederer LI, et al. The business case for quality mental health services: why employers should care about the mental health and well-being of their employees. J Occup Environ Med 2002 Apr; 44 (4): 320-30
53. Regier DA, Narrow WE, Rae DS, et al. The de facto US mental and addictive disorders service system: epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry 1993 Feb; 50 (2): 85-94
54. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 1994 Jan; 51 (1): 8-19
55. Judd LL, Akiskal HS. The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases. J Affect Disord 2003 Jan; 73 (1-2): 123-31
56. Weissman MM, Bland RC, Canino GJ, et al. Cross-national epidemiology of major depression and bipolar disorder. JAMA 1996 Jul 24/31; 276 (4): 293-9
57. Weissman MM, Gameroff MJ. Cross-national epidemiology of mood disorders: an update [abstract] [online]. Available from URL: http://www.pasteur.fr/ applica-tions/euroconf/depression/weissman.pdf [Accessed 2004 May 24]
58. Kleinman LS, Lowin A, Flood E, et al. Costs of bipolar disorder. Pharmacoeconomics 2003; 21 (9): 601-22
59. Murray CJ, Lopez AD, editors. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge (MA): Harvard University Press, 1996
60. Wyatt RJ, Henter I. An economic evaluation of manic-depressive illness: 1991. Soc Psychiatry Psychiatr Epidemiol 1995 Aug; 30 (5): 213-9
61. Begley CE, Annegers JF, Swann AC, et al. The lifetime cost of bipolar disorder in the US: an estimate for new cases in 1998. Pharmacoeconomics 2001; 19 (5 Pt1): 483-95
62. Das Gupta R, Guest JF. Annual cost of bipolar disorder to UK society. Br J Psychiatry 2002 Mar; 180: 227-33
63. Access Economics. Bipolar disorder: costs: an analysis of the burden of bipolar disorder and related suicide in Australia [online]. Melbourne: SANE Australia, 2003. Available from URL: http://www.sane.org/images/assets/ Research_re-ports_and_images/bipolar_costs.pdf [Accessed 2004 May 24]
64. Peele PB, Xu Y, Kupfer DJ. Insurance expenditures on bipolar disorder: clinical and parity implications. Am J Psychiatry 2003 Jul; 160 (7): 1286-90
65. Sasane R, de Lissovoy G, Matza LS, et al. Work loss associated with bipolar disorder [abstract]. Value Health 2004 May/Jun; 7 (3): 280
66. Bryant-Comstock L, Stender M, Devercelli G. Health care utilization and costs among privately insured patients with bipolar I disorder. Bipolar Disord 2002 Dec; 4 (6): 398-405
67. Simon GE, Unützer J. Health care utilization and costs among patients treated for bipolar disorder in an insured population. Psychiatr Serv 1999 Oct; 50 (10): 1303-8
68. Birnbaum HG, Shi L, Dial E, et al. Economic consequences of not recognizing bipolar disorder patients: a cross-sectional descriptive analysis. J Clin Psychiatry 2003 Oct; 64 (10): 1201-9
69. Stimmel GL. The economic burden of bipolar disorder. Psychiatr Serv 2004 Feb; 55 (2): 117-8
70. Bridle C, Palmer S, Bagnall AM, et al. A rapid and systematic review and economic evaluation of the clinical and cost-effectiveness of newer drugs for treatment of mania associated with bipolar affective disorder. Health Technol Assess 2004 May; 8 (19): 1-187
71. Li J, McCombs JS, Stimmel GL. Cost of treating bipolar disorder in the California Medicaid (Medi-Cal) program. J Affect Disord 2002 Sep; 71 (1-3): 131-9
72. Rush AJ, Crimson ML, Kashner TM, et al. Texas Medication Algorithm Project, phase 3 (TMAP-3): rationale and study design. J Clin Psychiatry 2003 Apr; 64 (4): 357-69
73. Sachs GS, Thase ME, Otto MW, et al. Rationale, design, and methods of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Biol Psychiatry 2003 Jun 1; 53 (11): 1028-42
74. Goldberg JF, Harrow M, Grossman LS. Course and outcome in bipolar affective disorder: a longitudinal follow-up study. Am J Psychiatry 1995 Mar; 152 (3): 379-84
75. American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry 2002 Apr; 159 (4 Suppl.): 1-50
76. Silverstone T. Is lithium still the maintenance treatment of choice for bipolar disorder? CNS Drugs 2000 Aug; 14 (2): 81-94
77. Zhu B, Zhao Z, Cooper LM. Patterns of pharmacologic treatment for patients with bipolar disorder [abstract]. Value Health 2004 May/Jun; 7 (3): 284
78. Cooper LM, Zhao Z, Zhu B. Trends in pharmacologic treatment for patients with bipolar: 1992-2002 [abstract]. Value Health 2004 May/Jun; 7 (3): 284
79. deLay N, Stensland MD, Viswanathan S, et al. The costs of poly-pharmacy, non-drug treatment, number of drugs and switching for bipolar disorder [abstract]. Value Health 2004 May/Jun; 7 (3): 274
80. Russo P, Smith MW, Dirani R, et al. Pharmacotherapy patterns in the treatment of bipolar disorder. Bipolar Disord 2002 Dec; 4 (6): 366-77
81. Sajatovic M, Davies M, Hrouda DR. Enhancement of treatment adherence among patients with bipolar disorder. Psychiatr Serv 2004 Mar; 55 (3): 264-9
82. Schumann C, Lenz G, Berghofer A, et al. Non-adherence with long-term prophy-laxis; a 6-year follow-up study of affectively ill patients. Psychiatry Res 1999 Dec 27; 89 (3): 247-57
83. Scott J, Pope M. Self-reported adherence to treatment with mood stabilizers, plasma levels, and psychiatric hospitalization. Am J Psychiatry 2002 Nov; 159 (11): 1927-9
84. Berk M, Berk L, Castle D. A collaborative approach to the treatment alliance in bipolar disorder. Bipolar Disord 2004 Dec; 6 (6): 504-18
85. Rivas-Vazquez RA, Johnson SL, Rey GJ, et al. Current treatments for bipolar disorder: a review and update for psychologists. Prof Psychol Res Pr 2002 Apr; 33 (2): 212-23
86. Strakowski SM, DelBello MP, Adler CM. Comparative efficacy and tolerability of drug treatments for bipolar disorder. CNS Drugs 2001; 15 (9): 701-18
87. Tondo L, Baldessarini RJ, Floris G. Long-term clinical effectiveness of lithium maintenance treatment in types I and II bipolar disorders. Br J Psychiatry 2001 Jun; 178 Suppl. 41: s184-90
88. Yatham LN, Kusumakar V, Calabrese JR, et al. Third generation anticonvulsants in bipolar disorder: a review of efficacy and summary of clinical recommenda-tions. J Clin Psychiatry 2002 Apr; 63 (4): 275-83
89. Lyseng-Williamson KA, Perry CM. Aripiprazole: in acute mania associated with bipolar I disorder. CNS Drugs 2004; 18 (6): 367-76
90. Masan PS. Atypical antipsychotics in the treatment of affective symptoms: a review. Ann Clin Psychiatry 2004 Jan-Mar; 16 (1): 3-13
91. Yatham LN. Efficacy of atypical antipsychotics in mood disorders. J Clin Psychopharmacol 2003 Jun; 23 (3 Suppl. 1): S9-14
92. Wu EQ, Birnbaum HG, Greenberg P, et al. Drug treatment patterns of bipolar disorder and associated costs [abstract]. Value Health 2004 May/Jun; 7 (3): 273
93. Shi L, Namjoshi MA, Zhang F, et al. Olanzapine versus haloperidol in the treatment of acute mania: clinical outcomes, health-related quality of life and work status. Int Clin Psychopharmacol 2002 Sep; 17 (5): 227-37
94. Goldberg JF, Truman CJ. Antidepressant-induced mania: an overview of current controversies. Bipolar Disord 2003 Dec; 5 (6): 407-20
95. Jindal RD, Thase ME. Integrating psychotherapy and pharmacotherapy to improve outcomes among patients with mood disorders. Psychiatr Serv 2003 Nov; 54 (11): 1484-90
96. Cerbone MJ, Mayo JA, Cuthbertson BA, et al. Group therapy as an adjunct to medication in the management of bipolar affective disorder. Group 1992 Fall; 16 (3): 174-87
97. Colom F, Vieta E, Martinez-Aran A, et al. A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. Arch Gen Psychiatry 2003 Apr; 60 (4): 402-7
98. Miklowitz DJ, George EL, Richards JA, et al. A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder. Arch Gen Psychiatry 2003 Sep; 60 (9): 904-12
99. Lam DH, Watkins ER, Hayward P, et al. A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder: outcome of the first year. Arch Gen Psychiatry 2003 Feb; 60 (2): 145-52
100. Goff V, Pittman P. Making the business case for improving mental health care: how to maximize corporate resources [online]. Washington, DC: Academy Health, National Health Care Purchasing Institute, 2002 Sep. Available from URL: http://www.nhcpi.net/pdf/mentalhealth.pdf [Accessed 2004 May 24]
101. Lewis L. The role of mental health patient organizations in disease management: focus on the US National Depressive and Manic-Depressive Association. Dis Manage Health Outcomes 2001; 9 (11): 607-17
102. Brady M, Reznicek L, Witheridge T. Best mental health practices in the workplace: report on Minnesota employers. Minneapolis (MN): Mental Health Association of Minnesota, 2000
103. Gabriel P. Mental health in the workplace: situation analysis, United States [online]. Geneva: International Labour Organization, 2000. Available from URL: http://www.ilo.org/public/english/employment/skills/disability/ download/usa.pdf [Accessed 2004 May 24]
104. US Equal Employment Opportunity Commission. EEOC enforcement guidance on the Americans with Disabilities Act and psychiatric disabilities [online]. Avail-able from URL: http://www.eeoc.gov/policy/docs/psych.html [Accessed 2005 Jan 11]
105. National Institute of Mental Health. What to do when an employee is depressed: a guide for supervisors. Bethesda (MD): National Institutes of Health; 1996. NIH publication no. 96-3919
106. Teich JL, Buck JA. Datapoints: mental health services in employee assistance programs, 2001. Psychiatr Serv 2003 May; 54 (5): 611
107. Federal Occupational Health. Documenting the value of employee assistance programs [online]. Washington, DC: Department of Health and Human Ser-vices, Federal Occupational Health, 2003 Sep. Available from URL: http:// www.foh.dhhs.gov/Public/whatwedo/eap/EAPvalue.pdf [Accessed 2004 May 24]
108. Duckworth KM. Job accommodation network: work-site accommodation ideas for persons with psychiatric disabilities [online]. Available from URL: http:// www.jan.wvu.edu/media/Psychiatric.html [Accessed 2005 Jan 11]
109. Duckworth KM. Job accommodation network: accommodating workers with bipolar disorder [online]. Available from URL: http:// www.jan.wvu.edu/media/ BiPolar.html [Accessed 2005 Jan 11]
110. MacDonald-Wilson K. Frequently asked questions about employees with psychiat-ric disabilities: tips and resources on the ADA, job accommodations, and supervision. Boston (MA): Trustees of Boston University, Center for Psychiat-ric Rehabilitation, 1997
111. Job accommodation network [online]. Available from URL: http:// www.jan.wvu.edu [Accessed 2005 Jan 11]
112. The Center for Psychiatric Rehabilitation at Boston University. Reasonable accommodations for people with psychiatric disabilities: an on-line resource for employers and educators [online]. Available from URL: http://www.bu.edu/ cpr/reasaccom [Accessed 2005 Jan 11]
113. Goldman W. Economic grand rounds: is there a shortage of psychiatrists? Psychiatr Serv 2001 Dec; 52 (12): 1587-9
114. Rao NR. Recent trends in psychiatry residency workforce with special reference to international medical graduates. Acad Psychiatry 2003 Winter; 27 (4): 269-76
115. Cuffel BJ, Goldman W, Schlesinger H. Does managing behavioral health care services increase the cost of providing medical care? J Behav Health Serv Res 1999 Nov; 26 (4): 372-80
116. Grazier KL, Eselius LL, HU TW, et al. Effects of a mental health carve-out on use, costs, and payers: a four-year study. J Behav Health Serv Res 1999 Nov; 26 (4): 381-9
117. Goldfarb N, Weston C, Hartmann CW, et al. Impact of appropriate pharmaceutical therapy for chronic conditions on direct medical costs and workplace productiv-ity: a review of the literature. Dis Manag 2004 Spring; 7 (1): 61-75
118. Pelletier KR. A review and analysis of the clinical- and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: 1995-1998 update. Am J Health Promot 1999 Jul-Aug; 13 (6): 333-45
119. Pelletier KR. A review and analysis of the clinical- and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: 1998-2000 update. Am J Health Promot 2001 Nov-Dec; 16 (2): 107-16
120. Blassingame KM. Let the sun shine in: medication, talk therapy solutions offer help, hope to depression sufferers. Employee Benefit News 2003 Dec 1; 17 (15): 25-6
121. Langlieb AM, Kahn JP. ROI from mental healthcare is more than anecdotal. Employee Benefit News 2004 Jan 1; 18 (1): 11-4