Prevalence and Effects of Mood Disorders on Work Performance in a Nationally Representative Sample of U.S. Workers

OBJECTIVE: Research on the workplace costs of mood disorders has focused largely on major depressive episodes (MDE). Bipolar disorder (BPD) has been overlooked both by failing to distinguish MDE due to major depressive disorder (MDD) versus BPD and by failing to evaluate the workplace costs of mania and hypomania. METHOD: The National Comorbidity Survey Replication (NCS-R) assessed DSM-IV MDD and BPD with the WHO Composite International Diagnostic Interview (CIDI) and assessed work impairment with the WHO Health and Work Performance Questionnaire (HPQ). Regression analysis of MDD and BPD predicting HPQ among workers (n = 3378) was used to estimate the workplace costs of mood disorders. RESULTS: 1. 1% of workers met CIDI criteria for 12-month BPD (bipolar I or bipolar II) and 6. 4% for 12-month MDD. BPD was associated with 65. 5 and MDD with 27. 2 annual lost workdays per ill worker. Subgroup analysis showed that the higher work loss associated with BPD than MDD is due to more severe and persistent MDE in BPD than MDD rather than to stronger effects of mania-hypomania than depression. Annual human capital loss per ill worker was estimated at 9619 for BPD and 4426 for MDD. Annual projections to the US labor force were 14. 1 billion for BPD and 36. 6 billion for MDD. CONCLUSIONS: Employer interest in the workplace costs of mood disorders should be broadened beyond MDD to include BPD. Effectiveness trials are needed to study the return on employer investment of coordinated programs for workplace screening and treatment of BPD and MDD.