Depression and Poor Mental Health’s Impact on Work

Depression, Disability Days, and Days Lost From Work in a Prospective Epidemiologic SurveyW. 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 symptoms to disability days and days lost from work in 2980 participants in 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 risk of disability (95% confidence interval, 1.64 to 13.88), and persons with minor depression with mood disturbance, but not major depression, had a 1.55 times greater risk (95% confidence interval, 1.00 to 2.40). Because of its prevalence, individuals with minor depression were associated with 51% more disabilitydays in the community than persons with major depression. This group was also at increased risk of having a concomitant anxiety disorder or developing major depression within 1 year. We conclude that the threshold for identifying clinically significant depression may need to be reevaluated to include persons with fewer symptoms but measurable morbidity. Only by changing our nosology can the societal impact of depression be adequately addressed.

X Variables in Research Nervousness

Calm & Peaceful

Blue

Happy

Depressed

Overall Mental Health

Y Variables in Research Weeks R Worked any Job in 2007

Average Hours R Worked in a Week

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

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

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

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

--------------------------------------------------------------------------------R55117.00 [FP_YMNTHLTH] Survey Year: 2000PRIMARY 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: 5-92464 10 TO 145371 15 TO 20

# 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

"R4894000“(2000) "S0921200“(2002) "S4682300“(2004) "S8332700“(2006) "T0038800“(2007)

3 2 1 1 41

4 4 4 -5 -5

4 3 4 -5 -5

4 4 4 4 39

3 2 3 4 40

4 4 4 4 43

4 2 -5 3 -5

4 4 4 4 27

3 3 4 4 46

4 4 3 3 44

4 3 3 3 42

4 4 4 4 50

3 4 4 4 52

-5 -5 -5 -5 -5

3 3 4 3 -5

3 4 3 4 0

4 -5 4 -5 -5

2 3 4 -2 31

3 1 4 3 -5

3 2 4 -5 -5

4 4 4 4 44

3 4 4 -5 52

3 3 3 3 52

1 4 4 4 -3

2 3 4 4 36

-2 2 1 4 0

One-way ANOVA: "T0038800" versus "S0921200"

Source DF SS MS F P"S0921200" 4 6329 1582 3.70 0.014Error 31 13264 428Total 35 19593

S = 20.69 R-Sq = 32.30% R-Sq(adj) = 23.56%

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