title: Job performance deficits due to depression.
abstract: OBJECTIVE
  This study assessed the relationship between depression severity and job performance among employed primary care patients.
  
  
  METHODS
  In a 2001-2004 longitudinal observational study of depression's affect on work productivity, 286 patients with DSM-IV major depressive disorder and/or dysthymia were compared to 93 individuals with rheumatoid arthritis, a condition associated with work disability, and 193 depression-free healthy control subjects. Participants were employed at least 15 hours per week, did not plan to stop working, and had no major medical comorbidities. Measures at baseline, six, 12, and 18 months included the Work Limitations Questionnaire for work outcomes, and the Patient Health Questionnaire-9 for depression.
  
  
  RESULTS
  At baseline and each follow-up, the depression group had significantly greater deficits in managing mental-interpersonal, time, and output tasks, as measured by the Work Limitations Questionnaire: The rheumatoid arthritis group's deficits in managing physical job demands surpassed those of either the depression or comparison groups. Improvements in job performance were predicted by symptom severity. However, the job performance of even the "clinically improved" subset of depressed patients remained consistently worse than the control groups.
  
  
  CONCLUSIONS
  Multiple dimensions of job performance are impaired by depression. This impact persisted after symptoms have improved. Efforts to reduce work-impairment secondary to depression are needed.
authors.affiliation: The Health Institute, Tufts-New England Medical Center, 750 Washington St., No. 345, Boston, MA 02111, USA. dadler@tufts-nemc.org
authors.forename: David A
authors.initials: DA
authors.lastname: Adler
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: McLaughlin
authors.forename: William H
authors.initials: WH
authors.lastname: Rogers
authors.forename: Hong
authors.initials: H
authors.lastname: Chang
authors.forename: Leueen
authors.initials: L
authors.lastname: Lapitsky
authors.forename: Debra
authors.initials: D
authors.lastname: Lerner
mesh_terms: D000041:Absenteeism; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D019263:Dysthymic Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D004526:Efficiency; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009790:Occupations / Q000592:standards / Q000706:statistics & numerical data; D015995:Prevalence; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D014481:United States; D014938:Work Capacity Evaluation