The Workplace Burden of Depression
Depression has a very negative effect on the individual suffering from it. Studies have however shown that depression has far more reaching effects than just the individual – there are direct correlations between depression, absenteeism and decreased productivity.
Major Depressive Disorder affects approximately 121 million people worldwide. The World Health Organization estimates depression will be among the highest-ranking causes of disability in developed countries by 2020, second only to ischemic heart disease worldwide. It can happen to anyone of any age, race or ethnicity; however, women are nearly twice as likely to experience depression as men. Although it is one of the most frequently seen psychiatric disorders in the primary care setting, it often goes undiagnosed or is under-treated. This may be because depressed people often present with physical symptoms rather than emotional complaints; in one large study, 69 percent of patients with MDD reported only physical symptoms as the reason for visiting their physician.
Complete elimination of symptoms, or remission, is the primary goal of depression treatment. Treating the full spectrum of emotional and physical symptoms to remission significantly decreases a patient’s risk of relapse.
Depression, well known to reduce workplace productivity, causes significantly greater productivity declines when accompanied by common co-occurring conditions such as fatigue, sleep problems or anxiety, according to a large new study presented last month at the American Psychiatric Association’s 160th Annual Meeting in San Diego. The study also showed that co-occurring fatigue or sleep problems significantly increased depression-related healthcare costs.
In the study, which used an integrated database of healthcare claims and surveys of almost 14 000 employees at two large U.S. firms, researchers analyzed data on healthcare spending and “presenteeism” (employees’ estimates of their own productivity while at work) to assess the impact of depression and other chronic conditions.
Overall, among the ten most prevalent physical and mental conditions measured, depression had the single largest negative effect on work productivity. That effect was magnified when fatigue, sleep problems and anxiety – conditions that often co-occur with depression – were also present.
Some of the consequences of persistent depression include poor function (work, family and social), poor prognosis (potential for earlier relapse), greater health service utilization and health care costs, and increased morbidity and mortality. The World Health Organisation predicts that by 2020, depression will be the second-largest cause of the global health burden. Other studies, conducted over the last ten years, have further demonstrated the correlation between depression and absenteeism, as well as “presenteeism” (lost productivity while on the job), further reinforcing the high price tag resulting from the condition.
According to a national study, the results of which were published in 1998, the average days lost from work because of illness are: depression – 40 days, heart disease – 37 days, other mental-health disorders – 37 days, lower-back pain – 33 days, hypertension – 28 days and diabetes – 26 days. Furthermore, a study by the Massachusetts Institute of Technology (MIT), found that the costs of depression in the United States is on a par with the costs of heart disease and AIDS, and are higher than strokes, multiple sclerosis and cerebral palsy.
Depression is under treated and often misdiagnosed – because of unreported symptoms by patients, the stigma attached to depression and a lack of knowledge by primary care physicians – who usually serve as the first-line providers for depression.
These studies concluded that the combined burden of costs from lost productivity and low level of treatment for those with depression present cost-effective opportunities for improving depression-related outcomes in the workforce – primarily through appropriate medications, psychotherapy and disease management.
“While depression itself has a significant economic impact, the negative effect on both workplace productivity and healthcare costs can be considerably increased when employees who are depressed also suffer from other conditions,” said Ronald C. Kessler, Ph.D., Professor of Health Care Policy, Harvard Medical School, Boston, Massachusetts. “These findings suggest we should aim to identify and minimize multiple factors associated with depression early to reduce this burden.”
“Companies can help by encouraging employees to go for early screening for depression, providing education within the workplace about depression, implementing employee assistance programmes which are confidential, and encouraging patients to seek treatment,” said Dr Ralph Swindle, a senior research scientist for Lilly in the United States, addressing media on new insights on depression: assessing impact and reaching remission in the real world at the congress last week. “Workplaces should also encourage healthy living and exercise, an excellent adjunct to the treatment and prevention of depression. Employers should also take a look at how the employee’s medical insurance is structured, so as to ensure that cost or access does not heighten the barrier to treatment”.
For more information about depression, speak to your doctor or visit www.depressionhurts.co.za Ends
