Am J Psychiatry 161:1885-1891, October 2004
© 2004 American Psychiatric Association
Effects of Major Depression on Moment-in-Time Work Performance
Philip S. Wang, M.D., Dr.P.H.,
Arne L. Beck, Ph.D.,
Pat Berglund, M.B.A.,
David K. McKenas, M.D., M.P.H.,
Nicolaas P. Pronk, Ph.D.,
Gregory E. Simon, M.D., M.P.H., and
Ronald C. Kessler, Ph.D.
OBJECTIVE: Although major depression is thought to have substantial negative effects on work performance, the possibility of recall bias limits self-report studies of these effects. The authors used the experience sampling method to address this problem by collecting comparative data on moment-in-time work performance among service workers who were depressed and those who were not depressed. METHOD: The group studied included 105 airline reservation agents and 181 telephone customer service representatives selected from a larger baseline sample; depressed workers were deliberately oversampled. Respondents were given pagers and experience sampling method diaries for each day of the study. A computerized autodialer paged respondents at random time points. When paged, respondents reported on their work performance in the diary. Moment-in-time work performance was assessed at five random times each day over a 7-day data collection period (35 data points for each respondent). RESULTS: Seven conditions (allergies, arthritis, back pain, headaches, high blood pressure, asthma, and major depression) occurred often enough in this group of respondents to be studied. Major depression was the only condition significantly related to decrements in both of the dimensions of work performance assessed in the diaries: task focus and productivity. These effects were equivalent to approximately 2.3 days absent because of sickness per depressed worker per month of being depressed. CONCLUSIONS: Previous studies based on days missed from work significantly underestimate the adverse economic effects associated with depression. Productivity losses related to depression appear to exceed the costs of effective treatment.
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