OBJECTIVES: Major depressive disorder (MDD) is a common mood disorder that exerts a tremendous individual and societal burden. This study assessed differences in work productivity and activity impairment (WPAI) in respondents with diagnosed depression across severity of depression (defined based on Patient Health Questionnaire 9-item [PHQ-9] scores) in the United States (US).

METHODS: Data were obtained from the 2017 US National Health and Wellness Survey, a self-administered, internet-based, nationwide survey of adults. Those aged <65 years with a self-reported diagnosis of depression (n=8,853) were included in the study and categorized by level of depression severity at time of survey (none/minimal: n=1,876, mild: n=2,801, moderate: n=1,938, moderately severe: n=1,376, severe: n=862) based on PHQ-9 scores. Multivariable models assessed presenteeism, absenteeism, overall work productivity loss, and activity impairment via the WPAI questionnaire as a function of PHQ-9 scores, controlling for covariates (e.g., demographics, comorbidities, body mass index).

RESULTS: Respondents diagnosed with depression averaged 39.9 (SD=14.1) years of age and were 71.0% female, 45.4% reported living with a partner/married and 56.6% were employed. Among those employed, average absenteeism reported was 9.0% (SD=20.0%), presenteeism 29.0% (SD=26.4%) and overall work productivity 32.0% (SD=28.8%). Average activity impairment reported was 39.0% (SD=29.0%). Among respondents with MDD, unemployment rates, work productivity impairment, and activity impairment increased as MDD severity increased (All Ps<0.001). After controlling for covariates, a 1-point increase in PHQ-9 score was associated with an expected average increase in absenteeism of 6.9%, presenteeism of 5.1%, work impairment of 5.0%, and activity impairment of 4.6% (All Ps<0.001).

CONCLUSIONS: Individuals with depression experience a substantial impact on functioning which is associated with their employment status, ability to work productively, and ability to perform regular activities. As depression severity increases, individuals experience increased impairments in their ability to function.