Effects of Depression on Work Loss and Disability Bed Days in Individuals With Diabetes

Diabetes is highly prevalent in the U.S. and is associated with significant disability and increased health care costs (1–3). Depression is also highly prevalent and is a leading cause of disability, work place absenteeism, diminished or lost productivity, and increased use of health care resources (4,5). Coexisting depression occurs in 10–30% of people with diabetes, and people with diabetes have twofold increased odds of having depression compared with people without diabetes (6,7). The objectives of this study were to determine 1 ) the effect of coexisting depression on mean work loss and disability bed days and 2 ) the effect of coexisting depression on odds of extended (defined as ≥7 days) work loss and disability bed days in individuals with and without diabetes. It was hypothesized that coexisting depression in people with diabetes would be associated with significant increases in mean disability days and odds of extended disability days. Data from the sample adult core of 1999 National Health Interview Survey (NHIS) (8) were analyzed. The NHIS is a nationally representative household survey of U.S. adults aged ≥18 years. The sample is selected by a complex sampling design involving stratification, clustering, and multistage sampling, with a nonzero probability of selection for each person. Final weights allow estimates from the NHIS to be generalized to the adult civilian population of the U.S. (9). Work loss …