title: Screening for depression in the occupational health setting.
abstract: BACKGROUND
  The cost of workplace absenteeism and presenteeism due to depression in the USA is substantial.
  
  
  OBJECTIVE
  To assess the frequency of depression and its impact at the point of care in an occupational health (OH) practice.
  
  
  METHODS
  Patients presenting to an OH practice completed a standardized depression screening tool and were compared to an unscreened group in the same clinic. Respondents with a nine-item Patient Health Questionnaire (PHQ-9) score >15 and untreated for depression were referred for further evaluation per usual practice. A comparison group of unscreened patients were selected from the same clinic from 1 year prior and records were reviewed for evidence of prior depression, treatment and outcomes. After 1 year, frequency of depression, PHQ-9 scoring for screened patients, days absent from work, days on restricted duties and permanent restrictions were recorded for both groups.
  
  
  RESULTS
  Two hundred and five patients were screened for depression. Screening was associated with increased frequency of a diagnosis of current depression (30 versus 4%; P < 0.05). Screening was associated with similar rates of absenteeism but lower number of days on restricted duties (97 versus 159 days; P < 0.001). After adjusting for age, sex, history of and treatment for depression, screening was associated with lower odds of being on work restrictions [odds ratio (OR) 0.55; 95% confidence interval (CI) 0.38-0.78] or permanent restrictions (OR 0.35; 95% CI 0.23-0.52).
  
  
  CONCLUSIONS
  Depression was common in this OH practice. Screening for depression, with appropriate recognition and referral, may reduce time for employed patients on restricted duties and permanent restrictions.
authors.affiliation: Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN 55905, USA, newcomb.richard@mayo.edu.
authors.forename: R D
authors.initials: RD
authors.lastname: Newcomb
authors.affiliation: Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: M W
authors.initials: MW
authors.lastname: Steffen
authors.affiliation: Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Breeher
authors.affiliation: Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: G M
authors.initials: GM
authors.lastname: Sturchio
authors.affiliation: Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Murad
authors.affiliation: Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Molella
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009786:Occupational Health Services / Q000379:methods*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: Depression; disability management; occupational health; screening.