Depression and poor mental health can significantly impact work productivity and performance. A 1990 study found that individuals with major depression had a 4.78 times greater risk of disability days compared to asymptomatic individuals, while those with minor depression had a 1.55 times greater risk. Minor depression was associated with more total disability days in the community than major depression due to its higher prevalence. The study concludes that the threshold for identifying clinically significant depression may need to be lowered to include individuals with fewer symptoms but still measurable negative impacts. Only by changing diagnostic classifications can the true societal burden of depression be adequately addressed.

1. Secondary Analysis Topic Depression and Poor Mental Health’s Impact on Work

2. Depression, Disability Days, and Days Lost From Work in a Prospective Epidemiologic Survey W. Eugene Broadhead, MD, PhD; Dan G. Blazer, MD, PhD; Linda K. George, PhD; Chiu Kit Tse, MSPH JAMA. 1990;264(19):2524-2528. AbstractWe describe the relationship of depression and depressive symptomsto disability days and days lost from work in 2980 participantsin the Epidemiologic Catchment Area Study in North Carolinaafter 1 year of follow-up. Compared with asymptomatic individuals,persons with major depression had a 4.78 times greater riskof disability (95% confidence interval, 1.64 to 13.88), andpersons with minor depression with mood disturbance, but notmajor depression, had a 1.55 times greater risk (95% confidenceinterval, 1.00 to 2.40). Because of its prevalence, individualswith minor depression were associated with 51% more disabilitydays in the community than persons with major depression. Thisgroup was also at increased risk of having a concomitant anxietydisorder or developing major depression within 1 year. We concludethat the threshold for identifying clinically significant depressionmay need to be reevaluated to include persons with fewer symptomsbut measurable morbidity. Only by changing our nosology canthe societal impact of depression be adequately addressed.

3. X Variables in Research Nervousness Calm & Peaceful Blue Happy Depressed Overall Mental Health

4. Y Variables in Research Weeks R Worked any Job in 2007 Average Hours R Worked in a Week

5. R UNHAPPY, SAD, DEPRESSED (MALE) [this youth] is unhappy, sad or depressed. Copyright Items: TM Achenbach. Reproduced by Permission 1179 0 Not true 486 1 Sometimes true 44 2 Often true ------- 1709 Refusal(-1) 1 Don't Know(-2) 3 TOTAL =========> 1713 VALID SKIP(-4) 7271 NON-INTERVIEW(-5) 0 Lead In: R06911.00[Default] Default Next Question: R06913.00

6. R UNHAPPY, SAD, DEPRESSED (FEMALE) [this youth] is unhappy, sad or depressed. Copyright Items: TM Achenbach. Reproduced by Permission 1070 0 Not true 472 1 Sometimes true 42 2 Often true ------- 1584 Refusal(-1) 2 Don't Know(-2) 2 TOTAL =========> 1588 VALID SKIP(-4) 7396 NON-INTERVIEW(-5) 0 Lead In: R06907.00[Default] Default Next Question: R06913.00 -------------------------------------------------------------------------------- R06912.00 [PC12-028] Survey Year: 1997 PRIMARY VARIABLE

7. R48940.00 [YSAQ-282G] Survey Year: 2000 PRIMARY VARIABLE HOW OFTEN R DEPRESSED IN LAST MONTH How much of the time during the last month have you felt so down in the dumps that nothing could cheer you up? 123 1 All of the time 457 2 Most of the time 2371 3 Some of the time 5077 4 None of the time ------- 8028 Refusal(-1) 44 Don't Know(-2) 7 TOTAL =========> 8079 VALID SKIP(-4) 1 NON-INTERVIEW(-5) 904 Lead In: R48939.00[Default] Default Next Question: R48941.00

8. S83327.00 [YSAQ-282G] Survey Year: 2006 PRIMARY VARIABLE HOW OFTEN R DEPRESSED IN LAST MONTH How much of the time during the last month have you felt so down in the dumps that nothing could cheer you up? 65 1 All of the time 274 2 Most of the time 1771 3 Some of the time 5265 4 None of the time ------- 7375 Refusal(-1) 47 Don't Know(-2) 137 TOTAL =========> 7559 VALID SKIP(-4) 0 NON-INTERVIEW(-5) 1425 Lead In: S83326.00[Default] Default Next Question: S83328.00

9. -------------------------------------------------------------------------------- R55117.00 [FP_YMNTHLTH] Survey Year: 2000 PRIMARY VARIABLE YOUTH MENTAL HEALTH SCALE Youth Report, Mental Health Index. Scores range from 5 to 20; higher scores indicate more positive mental health while lower scores indicate more emotional problems. 187 1 TO 9: 5-9 2464 10 TO 14 5371 15 TO 20

10. # WEEKS R WORKED ANY JOB YEAR 07 Number of weeks the respondent worked at any job during the year. 850 0: 0 Weeks 130 1 TO 5: 1-5 Weeks 161 6 TO 10: 6-10 Weeks 190 11 TO 15: 11-15 Weeks 204 16 TO 20: 16-20 Weeks 228 21 TO 25: 21-25 Weeks 252 26 TO 30: 26-30 Weeks 327 31 TO 35: 31-35 Weeks 696 36 TO 40: 36-40 Weeks 2591 41 TO 45: 41-45 Weeks 1103 46 TO 50: 46-50 Weeks 638 51 TO 999: 51+ Weeks ------- 7370 Refusal(-1) 0 Don't Know(-2) 0 Invalid Skip(-3) 48 TOTAL =========> 7418 VALID SKIP(-4) 0 NON-INTERVIEW(-5) 1566 Min: 0 Max: 52 Mean: 34.54 Lead In: T00387.00[Default] Default Next Question: T00389.00

12. One-way ANOVA: "T0038800" versus "S0921200" Source DF SS MS F P "S0921200" 4 6329 1582 3.70 0.014 Error 31 13264 428 Total 35 19593 S = 20.69 R-Sq = 32.30% R-Sq(adj) = 23.56%

13. Depression and work productivity: the comparative costs of treatment versus … GE Simon, C Barber, HG Birnbaum, RG … - … of Occupational and …, 2001 - journals.lww.comThis article discusses the impact of depression on work productivity and the potential for improved work performance associated with effective treatment. We undertook a review of the literature by means of a computer search using the following key terms: cost of illness, work loss, ...Cited by 98 - Related articles - BL Direct - All 4 versions Depression, disability days, and days lost from work in a prospective epidemiologic … WE Broadhead, DG Blazer, LK George, CK Tse - Jama, 1990 - Am Med AssocWe describe the relationship of depression and depressive symptoms to disability days and days lost from work in 2980 participants in the Epidemiologic Catchment Area Study in North Carolina after 1 year of follow-up. Compared with asymptomatic individuals, persons with major ...Cited by 947 - Related articles - All 4 versions

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