The Art of Health Promotion

from the journal abstract) Physicians regard individuals with dysthymia as having relatively normal levels of functioning. This study examines in detail the work impact of dysthymia in a population of employed primary care patients. As part of an observational study conducted between 2001 and 2003 in clinics associated with three health plans in Massachusetts, we compared 69 patients diagnosed with DSM-IV dysthymia without concurrent major depressive disorder to 175 depressionfree controls. Patients were employed at least 15 h per week, had no immediate plans to leave the labor market, and no major comorbid medical conditions. We assessed work absences and productivity loss due to on-the-job performance limitations (‘‘presenteeism’’). Patients with dysthymia, compared with controls, had less stable work histories and a greater frequency of significant problems at work. While absence rates were not significantly different (1.2 vs. 0.74 days, P,.09), individuals with dysthymia experienced significantly greater on-the-job productivity loss (6.3% vs. 2.8%, P,.0001). Dysthymia is an unrecognized cause of work impairment that has longterm negative consequences for individuals and their employers. The persistence of dysthymia with its serious impact on work functioning calls out for the development of new interventions. General Hospital Psychiatry. 2004 Jul–Aug 26(4): 269–276 Change in health risks and work productivity over time. Pelletier B, Boles M, Lynch W. We sought to examine the relationship between changes in health risks and changes in work productivity. Preand post-analysis was conducted on 500 subjects who participated in a wellness program at a large national employer. Change in health risks was analyzed using McNemar chisquare tests, and change in mean productivity was analyzed using paired t tests. A repeated measures regression model examined whether a change in productivity was associated with a change in health risks, controlling for age and gender. Individuals who reduced one health risk improved their presenteeism by 9% and reduced absenteeism by 2%, controlling for baseline risk level, age, gender, and interaction of baseline risk and risk change. In conclusion, reductions in health risks are associated with positive changes in work productivity. Self-reported work productivity may have utility in the evaluation of health promotion programs. J Occup Environ Med. 2004 Jul; 46(7):746–54. The application of two health and productivity instruments at a large employer. Ozminkowski RJ, Goetzel RZ, Chang