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Patient-reported Depression Severity Measured by the PHQ-9 and Impact on Work Productivity: Results From a Survey of Full-time Employees in the United States

Jain, Gagan PhD, MBA; Roy, Anuja PhD; Harikrishnan, Venkatesh MS; Yu, Shawn PhD; Dabbous, Omar MD, MPH; Lawrence, Carol PharmD

Journal of Occupational and Environmental Medicine: March 2013 - Volume 55 - Issue 3 - p 252–258
doi: 10.1097/JOM.0b013e31828349c9
Original Articles

Objective: To examine the burden of depression on work productivity.

Methods: Full-time employees with diagnosed depression were surveyed using the Patient Health Questionnaire for depression severity, and the Health and Work Performance Questionnaire and Work Productivity and Activity Impairment (WPAI) questionnaire for absenteeism and presenteeism.

Results: Of the 1051 employees with depression, 40.3% had no depressive symptoms at the time of the survey, 30.4% had mild depression, 15.8% had moderate depression, 7.8% had moderately severe depression, and 5.8% had severe depression. All levels of depression were associated with decreased work productivity. Presenteeism was positively associated with severity of depression (Health and Work Performance Questionnaire, P < 0.0001; WPAI, P < 0.0001). Absenteeism was significantly positively associated with severity of depression using the WPAI.

Conclusions: Decreased overall productivity was seen at all levels of depression, and as severity increased, presenteeism and absenteeism worsened.

From Xcenda® (Drs Jain and Lawrence), AmerisourceBergen Consulting Services, Palm Harbor, Fla; and Global Health Economics & Outcomes Research (Drs Roy, Yu, and Dabbous and Mr Harikrishnan), Takeda Pharmaceuticals International, Inc, Deerfield, Ill.

Address correspondence to: Gagan Jain, BPharm, MBA, PhD, 4114 Woodlands Pkwy, Ste 500, Palm Harbor, FL 34685 (

C.L. and G.J. report receiving consultancies from Takeda Pharmaceuticals International, Inc., the funder of the study. A.R., V.H., S.Y., and O.D. are employees of Takeda Pharmaceuticals International, Inc.

This study was supported by the Takeda Pharmaceutical Company, Ltd., as part of a joint clinical development program with H. Lundbeck A/S.

Authors Jain, Roy, Harikrishnan, Yu, Dabbous, and Lawrence have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM Editorial Board and planners have no financial interest related to this research.

©2013The American College of Occupational and Environmental Medicine