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Using Self-Reports of Symptom Severity to Measure and Manage Workplace Depression

Allen, Harris PhD; Hyworon, Zorianna BS; Colombi, Alberto MD

Journal of Occupational and Environmental Medicine: April 2010 - Volume 52 - Issue 4 - p 363-374
doi: 10.1097/JOM.0b013e3181d967e1
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Objectives: To test the workplace impact of depression when it is stratified by severity and considered in broader context.

Methods: Structural equation models of health risk appraisal data (n = 39,097) involving 41 measures of contextual characteristics, depression severity, health, and job performance.

Results: Approximately 15.7% exhibited mild depression, whereas 6.9% recorded moderate to severe symptoms. Depression severity exerted large effects on general health and productivity loss, with the mild group posting the largest aggregate impact. Adverse personal life impact and financial concerns more significantly affected moderate to severe depression. In contrast, factors more directly amenable to employer health management efforts (eg, stressful job) better predicted mild depression.

Conclusions: These results link depression to large health and productivity deficits. They call for public-private collaboration, parity in mental and physical health benefits, and resource allocation that is proportionate across the depression spectrum and facilitated by symptom severity screening.

From the School of Public Health (Dr Allen), Yale School of Medicine, New Haven, Conn; Harris Allen Group, LLC (Dr Allen), Brighton, Mass; Infotech (Ms Hyworon), Inc, Winnipeg, Manitoba, Canada; and PPG Industries, Inc (Dr Colombi), Pittsburgh, Pa.

The authors are solely responsible for all findings and conclusions presented in this article.

Address correspondence to: Harris Allen, PhD, Harris Allen Group, LLC, 116 Lake Shore Road #1, Brighton, MA 02135; E-mail:

A technical appendix for this article is available at

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©2010The American College of Occupational and Environmental Medicine