title: Comparing the effects on work performance of mental and physical disorders.
abstract: OBJECTIVE
  To estimate work loss days due to absenteeism and presenteeism associated with commonly occurring mental and physical disorders.
  
  
  METHODS
  In a nationally representative face-to-face survey (Netherlands Mental Health Survey and Incidence Study-2) including 4,715 workers, the presence of 13 mental and 10 chronic physical disorders was assessed using the Composite International Diagnostic Interview 3.0 and a physical disorder checklist. Questions about absent days due to illness and days of reduced quantitative and qualitative functioning while at work were based on the WHO Disability Assessment Schedule. Total work loss days were defined as the sum of the days of these three types of loss, where days of reduced functioning were counted as half. Both individual and population-level effects of disorders on work loss were studied, taking comorbidity into account.
  
  
  RESULTS
  Any mental disorder was associated with 10.5 additional absent days, 8.0 days of reduced-qualitative functioning and 12.0 total work loss days. For any physical disorder, the number of days was 10.7, 3.5 and 11.3, respectively. Adjusted for comorbidity, drug abuse, bipolar disorder, major depression, digestive disorders and panic disorder were associated with the highest number of additional total work loss days. At population-level, major depression, chronic back pain, respiratory disorders, drug abuse and digestive disorders contributed the most. Annual total work loss costs per million workers were estimated at <euro>360 million for any mental disorder; and <euro>706 million for any physical disorder.
  
  
  CONCLUSIONS
  Policies designed to lessen the impact of commonly occurring disorders on workers will contribute to a reduction in absenteeism and presenteeism. As the indirect costs of (mental) disorders are much higher than their medical costs, prevention and treatment of these conditions may be cost-effective.
authors.affiliation: Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands. rgraaf@trimbos.nl
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.forename: Marlous
authors.initials: M
authors.lastname: Tuithof
authors.forename: Saskia
authors.initials: S
authors.lastname: van Dorsselaer
authors.forename: Margreet
authors.initials: M
authors.lastname: ten Have
mesh_terms: D000041:Absenteeism; D000328:Adult; D002908:Chronic Disease / Q000191:economics* / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D017281:Cost of Illness; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data*; D004651:Employment; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D014937:Work / Q000191:economics / Q000706:statistics & numerical data*; D017132:Workplace / Q000191:economics / Q000706:statistics & numerical data