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The Longitudinal Prediction of Costs due to Health Care Uptake and Productivity Losses in a Cohort of Employees With and Without Depression or Anxiety

Geraedts, Anna S. MSc; Fokkema, Marjolein MSc; Kleiboer, Annet M. PhD; Smit, Filip PhD; Wiezer, Noortje W. PhD; Majo, Maria Cristina PhD; van Mechelen, Willem PhD, MD; Cuijpers, Pim PhD; Penninx, Brenda W. J. H. PhD

Journal of Occupational and Environmental Medicine: August 2014 - Volume 56 - Issue 8 - p 794–801
doi: 10.1097/JOM.0000000000000234
Original Articles

Objective: To examine how various predictors and subgroups of respondents contribute to the prediction of health care and productivity costs in a cohort of employees.

Methods: We selected 1548 employed people from a cohort study with and without depressive and anxiety symptoms or disorders. Prediction rules, using the RuleFit program, were applied to identify predictors and subgroups of respondents, and to predict estimations of subsequent 1-year health care and productivity costs.

Results: Symptom severity and diagnosis of depression and anxiety were the most important predictors of health care costs. Depressive symptom severity was the most important predictor for productivity costs. Several demographic, social, and work predictors did not predict economic costs.

Conclusions: Our data suggest that from a business perspective it can be beneficial to offer interventions aimed at prevention of depression and anxiety.

Supplemental Digital Content is Available in the Text.

From the Department of Clinical Psychology (Ms Geraedts, Ms Fokkema, and Drs Kleiboer, Smit, and Cuijpers), VU University; EMGO Institute for Health and Care Research (Ms Geraedts and Drs Kleiboer, Smit, van Mechelen, Cuijpers, and Penninx), VU University Amsterdam and VU University Medical Center Amsterdam; Body@Work (Ms Geraedts and Drs Kleiboer, Wiezer, van Mechelen, and Cuijpers), Research Center Physical Activity, Work and Health, TNO-VU-VUmc, Amsterdam; Trimbos Institute (Netherlands Institute of Mental Health and Addiction) (Dr Smit), Utrecht; TNO (Dr Wiezer), Hoofddorp; Departments of Public and Occupational Health (Dr van Mechelen) and Psychiatry (Dr Penninx), VU University Medical Center, Amsterdam; Department of Psychiatry (Dr Penninx), Leiden University Medical Centre; and Department of Psychiatry (Dr Penninx), University Medical Centre Groningen, University of Groningen, the Netherlands.

Address correspondence to: Anna S. Geraedts, MSc, Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands (

The infrastructure for the Netherlands Study of Depression and Anxiety study ( was funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (Zon-Mw, grant number 10-000-1002) and was supported by participating universities and mental health care organizations—VU University Medical Center, GGZ inGeest, Arkin, Leiden University Medical Center, GGZ Rivierduinen, University Medical Center Groningen, Lentis, GGZ Friesland, GGZ Drenthe, Scientific Institute for Quality of Healthcare (IQ healthcare), Netherlands Institute for Health Services Research (NIVEL), and Netherlands Institute of Mental Health and Addiction (Trimbos Institute).

This article is part of a PhD trajectory, which is funded by Body@Work Research Center for Physical Activity, Work and Health, Amsterdam, and the EMGO Institute for Health and Care Research, VU University Amsterdam and VU University Medical Center Amsterdam, the Netherlands.

Authors Geraedts, Fokkema, Kleiboer, Smit, Wiezer, Majo, van Mechelen, Cuijpers, and Penninx 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.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2014 by the American College of Occupational and Environmental Medicine