PERSISTENT DEPRESSION ON PRESENTEEISM AND PRODUCTIVITY LOSS IN CHINESE ADULTS WITH YOUNG-ONSET TYPE 2 DIABETES IN HONG KONG: A LONGITUDINAL ANALYSIS FROM THE PRISM-RCT
Author(s)
Hang Xu, Msc1, Tony CK O, MBChB1, Kelly TC Wong, Msc1, Sunny CS Chan, MBChB1, Nga Sze Wong, MBChB1, Eric Siu Him Lau, PhD1, Baoqi Fan, PhD1, Andrea OY Luk, MBChB , FHKCP, FHKAM1, Juliana CN Chan, MBChB, MD, MRCP, FRCP, FHKAM1, Juliana NM Lui, Msc, PhD2.
1The Chinese University of Hong Kong, Hong Kong, Hong Kong, 2Research Assistant Professor, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
1The Chinese University of Hong Kong, Hong Kong, Hong Kong, 2Research Assistant Professor, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
OBJECTIVES: Depression is common in individuals with young-onset type 2 diabetes (diagnosed before age 40) and may reduce work capacity in this working-age population. In this longitudinal study, we examined how depressive status and its trajectories are associated with presenteeism and overall work productivity.
METHODS: In the Precision Medicine to Redefine Insulin Secretion and Monogenic Diabetes-Randomized Controlled Trial (PRISM-RCT; January 2020-November 2024), Chinese adults with YOD completed the PHQ-9 at baseline and three annual follow-ups; depression was defined as PHQ-9 ≥7 (validated cutoff in Hong Kong). Presenteeism (≥2 episodes of working despite warranting sick leave in the past year) and self-rated work productivity (0-10 scale) were assessed. Associations of depression at each of the four annual assessments (baseline, years 1, 2 and 3 follow-up) and depressive trajectories [never (0/4), fluctuating (1-3/4), persistent (4/4)] with outcomes were analysed using adjusted logistic and linear regression.
RESULTS: Among 378 Chinese patients with YOD with complete data, 27.0% had depression (mean±SD age: 43.7±6.8 vs 44.2±6.2 years, men: 52.0% vs 60.1%, mean±SD duration of diabetes: 11.6±7.3 vs 11.0±5.8 years, in patients with depression vs those without depression). Overall, 49.7% reported presenteeism and mean productivity was 7.33±1.47. Those with baseline depression had higher odds of presenteeism (OR 2.07, 95%CI: 1.35, 3.22) and lower work productivity (β -0.37, 95%CI: -0.71, -0.04). Compared with never-depressed participants, those with persistent depression had nearly fivefold higher odds of presenteeism (OR 4.83, 95%CI: 2.37, 9.82) and about 8.8% reduction in work productivity (β −0.88, 95%CI: −1.37, 0.38). Fluctuating depression was associated with reduced productivity (β −0.49, 95%CI: −0.82, −0.16) but not significantly with presenteeism.
CONCLUSIONS: Persistent depression in Chinese adults with YOD is associated with elevated risks of presenteeism and reduced productivity, underscoring the importance of integrating regular mental health monitoring into structured diabetes management and strengthening workplace support to reduce productivity loss.
METHODS: In the Precision Medicine to Redefine Insulin Secretion and Monogenic Diabetes-Randomized Controlled Trial (PRISM-RCT; January 2020-November 2024), Chinese adults with YOD completed the PHQ-9 at baseline and three annual follow-ups; depression was defined as PHQ-9 ≥7 (validated cutoff in Hong Kong). Presenteeism (≥2 episodes of working despite warranting sick leave in the past year) and self-rated work productivity (0-10 scale) were assessed. Associations of depression at each of the four annual assessments (baseline, years 1, 2 and 3 follow-up) and depressive trajectories [never (0/4), fluctuating (1-3/4), persistent (4/4)] with outcomes were analysed using adjusted logistic and linear regression.
RESULTS: Among 378 Chinese patients with YOD with complete data, 27.0% had depression (mean±SD age: 43.7±6.8 vs 44.2±6.2 years, men: 52.0% vs 60.1%, mean±SD duration of diabetes: 11.6±7.3 vs 11.0±5.8 years, in patients with depression vs those without depression). Overall, 49.7% reported presenteeism and mean productivity was 7.33±1.47. Those with baseline depression had higher odds of presenteeism (OR 2.07, 95%CI: 1.35, 3.22) and lower work productivity (β -0.37, 95%CI: -0.71, -0.04). Compared with never-depressed participants, those with persistent depression had nearly fivefold higher odds of presenteeism (OR 4.83, 95%CI: 2.37, 9.82) and about 8.8% reduction in work productivity (β −0.88, 95%CI: −1.37, 0.38). Fluctuating depression was associated with reduced productivity (β −0.49, 95%CI: −0.82, −0.16) but not significantly with presenteeism.
CONCLUSIONS: Persistent depression in Chinese adults with YOD is associated with elevated risks of presenteeism and reduced productivity, underscoring the importance of integrating regular mental health monitoring into structured diabetes management and strengthening workplace support to reduce productivity loss.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
PCR13
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)