OBJECTIVES: This study examined the burden of depression on employees using measures of work productivity. METHODS: Individuals (≥18 years of age) employed full-time with diagnosed depression completed a Web-based computer-generated 25-minute survey in February 2010 (study population identified by Harris InteractiveTM). The survey used the Patient Health Questionnaire (PHQ-9) to assess depressive symptoms, and the Health and Work Performance Questionnaire (HPQ) and Work Productivity and Activity Impairment (WPAI) questionnaire to assess absenteeism and presenteeism. Higher scores represent more work missed on the HPQ (hours monthly) and WPAI (% time weekly) absenteeism scales. Higher scores on the HPQ presenteeism scale (measure of actual performance to possible performance, 0-100 scale), and lower scores on the WPAI presenteeism scale (% impairment past 7 days), represent better performance. Work productivity was assessed by depression severity using a trend test based on an analysis of covariance with age, gender and PHQ-9 score as independent variables. RESULTS: A total of 1051 full-time employees were evaluated (58% female, mean age 47 yrs). PHQ-9 scores indicated 423 (40.25%) employees with no depression symptoms, 319 (30.35%) with mild, 166 (15.79%) with moderate, 82 (7.80%) with moderately severe, and 61 (5.80%) with severe depression. All levels of depression were associated with decreased work productivity. Both the HPQ (presenteeism [81.04, 73.54, 68.61, 66.10, 61.48, no depression, mild, moderate, moderately severe, and severe depression groups, respectively], p<0.0001) and WPAI (absenteeism [0.92, 3.04, 4.55, 7.43, 14.00] and presenteeism [10.67, 26.17, 38.81, 44.68, 54.31], p<0.0001) showed progressive worsening of work productivity with increasing severity of depression. Pearson’s coefficient of correlation for WPAI with PHQ-9 was 0.3158 for absenteeism and 0.6055 for presenteeism (p<0.0001). CONCLUSIONS: Depression has a significant impact on work productivity as measured by the WPAI and HPQ. Presenteeism and absenteeism worsened with increasing depression severity, and decreased overall productivity was seen at all levels of depression severity.