title: Using self-reports of symptom severity to measure and manage workplace depression.
abstract: OBJECTIVE
  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.
authors.affiliation: School of Public Health, Yale School of Medicine, New Haven, Conn, USA. harris-allen@msn.com
authors.forename: Harris
authors.initials: H
authors.lastname: Allen
authors.forename: Zorianna
authors.initials: Z
authors.lastname: Hyworon
authors.forename: Alberto
authors.initials: A
authors.lastname: Colombi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D017132:Workplace; D055815:Young Adult