> Back to JHP Titles
The Workplace Costs of
Mood Disorders: Bringing Bipolar Spectrum Disorder into
the Equation
Ronald C. Kessler, PhD,1; Hagop S. Akiskal, MD,2; Jules
Angst, MD,3; Robert M.A. Hirschfeld, MD,4; Kathleen R. Merikangas,
PhD,5; Philip S. Wang, MD, DrPH,6; David J. Whitehouse, MD,7
1 Department of Health Care Policy, Harvard Medical School,
Boston, MA
2 International Mood Center, University of California San
Diego and VA Psychiatry Service, San Diego, CA
3 Zurich University Psychiatric Hospital, Zurich
4 Department of Psychiatry and Behavioral Sciences, University
of Texas Medical Branch, Galveston, Galveston, TX
5 Intramural Research Program, National Institute of Mental
Health, Bethesda, MD
6 National Institute of Mental Health, Bethesda, MD
7 United Behavioral Health, Waterbury, CT
REFERENCES
1. Murray CJL, Lopez AD. The Global Burden of Disease:
A Comprehensive Assessment of Mortality and Disability
from Diseases, Injuries and Risk Factors in 1990 and Projected
to 2020. Cambridge, MA: Harvard University Press; 1996.
2. Kessler RC, Berglund P, Demler O, et al. The epidemiology
of major depressive disorder: results from the National
Comorbidity Survey Replication (NCS-R). JAMA. 2003;289:3095-3105.
3. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters
EE. Prevalence, severity, and comorbidity of 12-month
DSM-IV disorders in the National Comorbidity Survey Replication.
Arch Gen Psychiatry. 2005;62:617-627.
4. Wells KB, Stewart A, Hays RD, et al. The functioning
and well-being of depressed patients: results from the
Medical Outcomes Study. JAMA. 1989;262:914-919.
5. Coryell W, Scheftner W, Keller M, Endicott J, Maser
J, Klerman GL. The enduring psychosocial consequences
of mania and depression. Am J Psychiatry. 1993;150:720-727.
6. MacQueen GM, Young LT, Joffe RT. A review of psychosocial
outcome in patients with bipolar disorder. Acta Psychiatr
Scand. 2001;103:163-170.
7. Calabrese JR, Hirschfeld RM, Reed M, et al. Impact
of bipolar disorder on a U.S. community sample. J Clin
Psychiatry. 2003;64:425-432.
8. Cassano GB, Perugi G, Maremmani I, Akiskal HS. Social
adjustment in dysthmia. In: Burton SW, Akiskal HS, eds.
Dysthymic Disorder. London [England]: Gaskell; 1990.
9. Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer
K. Functioning and well-being outcomes of patients with
depression compared with chronic general medical illnesses.
Arch Gen Psychiatry. 1995;52:11-19.
10. Judd LL, Paulus MP, Wells KB, Rapaport MN. Socioeconomic
burden of subsyndromal depressive symptoms and major depression
in a sample of the general population. Am J Psychiatry.
1996;153:1411-1417.
11. Rapaport MH, Judd LL. Minor depressive disorder and
subsyndromal depressive symptoms: functional impairment
and response to treatment. J Affect Disord. 1998;48:227-232.
12. McGuire T, Wells KB, Bruce ML, et al. Burden of illness.
Ment Health Serv Res. 2002;4:179-185.
13. Hirschfeld RM, Lewis L, Vornik LA. Perceptions and
impact of bipolar disorder: how far have we really come?
Results of the national depressive and manic-depressive
association 2000 survey of individuals with bipolar disorder.
J Clin Psychiatry. 2003;64:161-174.
14. Wells KB, Sherbourne CD. Functioning and utility for
current health of patients with depression or chronic
medical conditions in managed, primary care practices.
Arch Gen Psychiatry. 1999;56:897-904.
15. Bauer M, Unutzer J, Pincus HA, Lawson WB. Bipolar
disorder. Ment Health Serv Res. 2002;4:225-229.
16. Hirschfeld RM, Montgomery SA, Keller MB, et al. Social
functioning in depression: a review. J Clin Psychiatry.
2000;61:268-275.
17. Simon GE. Social and economic burden of mood disorders.
Biol Psychiatry. 2003;54:208-215.
18. Greenberg PE, Stiglin LE, Finkelstein SN, Berndt ER.
The economic burden of depression in 1990. J Clin Psychiatry.
1993;54:405-418.
19. Jarvinen D, Rice DP, Kelman S. Cost of illness studies:
an annotated bibliography 1988: U.S. Department of Health
and Human Services, Public Health Service, Alcohol, Drug
Abuse, and Mental Health Administration; 1988.
20. Greenberg PE, Kessler RC, Nells TL, Finkelstein SN,
Berndt ER. Depression in the workplace: an economic perspective.
In: Feighner JP, Boyer WF, eds. Selective Serotonin Reuptake
Inhibitors: Advances in Basic Research and Clinical Practice.
2nd ed. New York: John Wiley & Sons; 1996:327-363.
21. Wyatt RJ, Henter I. An economic evaluation of manic-depressive
illness--1991. Soc Psychiatry Psychiatr Epidemiol. 1995;30:213-219.
22. Kessler RC, Foster CL, Saunders WB, Stang PE. Social
consequences of psychiatric disorders, I educational attainment.
Am J Psychiatry. 1995;152:1026-1032.
23. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime
and 12-month prevalence of DSM-III-R psychiatric disorders
in the United States: results from the National Comorbidity
Survey. Arch Gen Psychiatry. 1994;51:8-19.
24. Kessler RC, Barber C, Beck A, et al. The World Health
Organization Health and Work Performance Questionnaire
(HPQ). J Occup Environ Med. 2003;45:156-174.
25. Kouzis AC, Eaton WW. Emotional disability days: prevalence
and predictors. Am J Public Health. 1994;84:1304-1307.
26. Kessler RC, Frank RG. The impact of psychiatric disorders
on work loss days. Psychol Med. 1997;27:861-873.
27. Stewart WF, Ricci JA, Chee E, Hahn SR, Morganstein
D. Cost of lost productive work time among US workers
with depression. JAMA. 2003;289:3135-3144.
28. Kessler RC, Greenberg PE, Mickelson KD, Meneades LM,
Wang PS. The effects of chronic medical conditions on
work loss and work cutback. J Occup Environ Med. 2001;43:218-225.
29. Sartorius N, Ustun TB. Mental Illness in Primary Care:
An International Study. New York: John Wiley & Sons;
1995.
30. Ormel J, Von Korff N, Ustun TB, Pini S, Korten A,
Oldehinkel T. Common mental disorders and disability across
cultures: results from the WHO collaborative study on
psychological problems in general health care. JAMA. 1994;272:1741-1748.
31. Zwerling C, Whitten PS, Sprince NL, et al. Workforce
participation by persons with disabilities: the national
health interview survey disability supplement, 1994 to
1995. J Occup Environ Med. 2002;44:358-364.
32. Olfson M, Fireman B, Weissman MM, et al. Mental disorders
and disability among patients in a primary care group
practice. Am J Psychiatry.
1997;154:1734-1740.
33. Kessler RC, Akiskal HS, Ames M, et al. The prevalence
and effects of mood disorders on work performance in a
nationally representative sample of US workers. Am J Psychiatry.
in press.
34. Kessler RC, Ames M, Hymel PA, et al. Using the World
Health Organization Health and Work Performance Questionnaire
(HPQ) to evaluate the indirect workplace costs of illness.
J Occup Environ Med. 2004;46:S23-37.
35. Winokur G, Coryell W, Keller M, Endicott J, Akiskal
H. A prospective follow-up of patients with bipolar and
primary unipolar affective disorder. Arch Gen Psychiatry.
1993;50:457-465.
36. Bauer M, Pfennig A. Epidemiology of bipolar disorders.
Epilepsia. 2005;46 Suppl 4:8-13.
37. Pini S, de Queiroz V, Pagnin D, et al. Prevalence
and burden of bipolar disorders in European countries.
Eur Neuropsychopharmacol. 2005;15:425-434.
38. Angst J, Gamma A, Benazzi F, Ajdacic V, Eich D, Rossler
W. Toward a re-definition of subthreshold bipolarity:
epidemiology and proposed criteria for bipolar-II, minor
bipolar disorders and hypomania. J Affect Disord. 2003;73:133-146.
39. Akiskal HS, Benazzi F. Optimizing the detection of
bipolar II disorder in outpatient private practice: toward
a systematization of clinical diagnostic wisdom. J Clin
Psychiatry. 2005;66:914-921.
40. Judd LL, Akiskal HS. The prevalence and disability
of bipolar spectrum disorders in the US population: re-analysis
of the ECA database taking into account subthreshold cases.
J Affect Disord. 2003;73:123-131.
41. Swann AC. Long-term treatment in bipolar disorder.
J Clin Psychiatry. 2005;66 Suppl 1:7-12.
42. Lam DH, Hayward P, Watkins ER, Wright K, Sham P. Relapse
prevention in patients with bipolar disorder: cognitive
therapy outcome after 2 years. Am J Psychiatry. 2005;162:324-329.
43. Rosenthal MB, Berndt ER, Donohue JM, Frank RG, Epstein
AM. Promotion of prescription drugs to consumers. N Engl
J Med. 2002;346:498-505.
44. Jacobs DG. National Depression Screening Day: educating
the public, reaching those in need of treatment, and broadening
professional understanding. Harv Rev Psychiatry. 1995;3:156-159.
45. Sturm R. Tracking changes in behavioral health services:
how have carve-outs changed care? J Behav Health Serv
Res. 1999;26:360-371.
46. Olfson M, Marcus SC, Druss B, et al. National trends
in the outpatient treatment of depression. JAMA. 2002;287:203-209.
47. Judd LL, Akiskal HS, Schettler PJ, et al. The long-term
natural history of the weekly symptomatic status of bipolar
I disorder. Arch Gen Psychiatry. 2002;59:530-537.
48. Calabrese JR, Hirschfeld RM, Frye MA, Reed ML. Impact
of depressive symptoms compared with manic symptoms in
bipolar disorder: results of a U.S. community-based sample.
J Clin Psychiatry. 2004;65:1499-1504.
49. Hirschfeld RM, Vornik LA. Recognition and diagnosis
of bipolar disorder. J Clin Psychiatry. 2004;65 Suppl
15:5-9.
50. Judd LL, Akiskal HS. Depressive episodes and symptoms
dominate the longitudinal course of bipolar disorder.
Curr Psychiatry Rep. 2003;5:417-418.
51. Birnbaum HG, Shi L, Dial E, Oster EF, Greenberg PE,
Mallett DA. Economic consequences of not recognizing bipolar
disorder patients: a cross-sectional descriptive analysis.
J Clin Psychiatry. 2003;64:1201-1209.
52. Bowden CL, Krishnan AA. Pharmacotherapy for bipolar
depression: an economic assessment. Expert Opin Pharmacother.
2004;5:1101-1107.
53. Bridle C, Palmer S, Bagnall AM, et al. A rapid and
systematic review and economic evaluation of the clinical
and cost-effectiveness of newer drugs for treatment of
mania associated with bipolar affective disorder. Health
Technol Assess. 2004;8:iii-iv, 1-187.
54. Rost K, Smith JL, Dickinson M. The effect of improving
primary care depression management on employee absenteeism
and productivity. A randomized trial. Med Care. 2004;42:1202-1210.
55. Wang PS, Simon G, Kessler RC. The economic burden
of depression and the cost-effectiveness of treatment.
Int J Methods Psychiatr Res. 2003;12:22-33.
56. Simon GE, Katzelnick DJ. Depression, use of medical
services and cost-offset effects. J Psychosom Res. 1997;42:333-344.
57. Simon GE, Unutzer J. Health care utilization and costs
among patients treated for bipolar disorder in an insured
population. Psychiatr Serv. 1999;50:1303-1308.
58. Katzelnick DJ, Simon GE, Pearson SD, et al. Randomized
trial of a depression management program in high utilizers
of medical care. Arch Fam Med. 2000;9:345-351.
59. Von Korff M, Katon W, Bush T, et al. Treatment costs,
cost offset, and cost-effectiveness of collaborative management
of depression. Psychosom Med. 1998;60:143-149.
60. Wang PS, Beck A, Berglund P, et al. Chronic medical
conditions and work performance in the health and work
performance questionnaire calibration surveys. J Occup
Environ Med. 2003;45:1303-1311.
61. Lish JD, Dime-Meenan S, Whybrow PC, Prince RA, Hirschfeld
RMA. The National Depressive and Manic-depressive Association
(DMDA) survey of bipolar members. J Affect Disord. 1994;31:281-294.
62. Keller MB, Klerman GL, Lavori PW, Fawcett JA, Coryell
W, Endicott J. Treatment received by depressed patients.
JAMA. 1982;248:1848-1855.
63. Keller MB, Lavori PW, Klerman GL, et al. Low levels
and lack of predictors of somatotherapy and psychotherapy
received by depressed patients. Arch Gen Psychiatry. 1986;43:458-466.
64. Wang PS, Berglund P, Kessler RC. Recent care of common
mental disorders in the United States : prevalence and
conformance with evidence-based recommendations. J Gen
Intern Med. 2000;15:284-292.
65. Young AS, Klap R, Sherbourne CD, Wells KB. The quality
of care for depressive and anxiety disorders in the United
States. Arch Gen Psychiatry. 2001;58:55-61.
66. Blanco C, Laje G, Olfson M, Marcus SC, Pincus HA.
Trends in the treatment of bipolar disorder by outpatient
psychiatrists. Am J Psychiatry. 2002;159:1005-1010.
67. Katon W, Robinson P, Von Korff M, et al. A multifaceted
intervention to improve treatment of depression in primary
care. Arch Gen Psychiatry. 1996;53:924-932.
68. Wells KB, Sherbourne C, Schoenbaum M, et al. Impact
of disseminating quality improvement programs for depression
in managed primary care: a randomized controlled trial.
JAMA. 2000;283:212-220.
69. Agency for Health Care Policy and Research. Depression
Guideline Panel, Vol 2: Treatment of major depression,
Clinical Practice Guideline, No 5. Rockville, MD: US Department
of Health and Human Services, Public Health Service, Agency
for Health Care Policy and Research; 1993.
70. American Psychiatric Association. Practice guideline
for the treatment of patients with bipolar disorder. Washington,
DC: American Psychiatric Association; 1994.
71. American Psychiatric Association. Practice guideline
for the treatment of patients with major depressive disorder,
2nd Edition. Washington, DC: American Psychiatric Association;
2000.
72. Narrow WE, Rae DS, Robins LN, Regier DA. Revised prevalence
estimates of mental disorders in the United States: using
a clinical significance criterion to reconcile 2 surveys'
estimates. Arch Gen Psychiatry. 2002;59:115-123.
73. Kessler RC, Berglund PA, Bruce ML, et al. The prevalence
and correlates of untreated serious mental illness. Health
Serv Res. 2001;36:987-1007.
74. Wang PS, Demler O, Kessler RC. Adequacy of treatment
for serious mental illness in the United States. Am J
Public Health. 2002;92:92-98.
75. Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke
BZ, Goodwin FK. The de facto US mental and addictive disorders
service system. Epidemiologic catchment area prospective
1-year prevalence rates of disorders and services. Arch
Gen Psychiatry. 1993;50:85-94.
76. Wells KB, Katon W, Rogers B, Camp P. Use of minor
tranquilizers and antidepressant medications by depressed
outpatients: results from the medical outcomes study.
Am J Psychiatry. 1994;151:694-700.
77. Wells KB, Sturm R, Sherbourne CD, Meredith L. Caring
for Depression. Cambridge, MA: Harvard University Press;
1996.
78. Katon W, Von Korff M, Lin E, et al. Collaborative
management to achieve treatment guidelines. Impact on
depression in primary care. JAMA. 1995;273:1026-1031.
79. Katon W, Von Korff M, Lin E, et al. Stepped collaborative
care for primary care patients with persistent symptoms
of depression: a randomized trial. Arch Gen Psychiatry.
1999;56:1109-1115.
80. Simon GE, Von Korff M, Rutter C, Wagner E. Randomised
trial of monitoring, feedback, and management of care
by telephone to improve treatment of depression in primary
care. BMJ. 2000;320:550-554.
81. Rost K, Nutting PA, Smith J, Werner JJ. Designing
and implementing a primary care intervention trial to
improve the quality and outcome of care for major depression.
Gen Hosp Psychiatry. 2000;22:66-77.
82. Unutzer J, Katon W, Callahan CM, et al. Collaborative
care management of late-life depression in the primary
care setting: a randomized controlled trial. JAMA. 2002;288:2836-2845.
83. Miranda J, Duan N, Sherbourne C, et al. Improving
care for minorities: can quality improvement interventions
improve care and outcomes for depressed minorities? Results
of a randomized, controlled trial. Health Serv Res. 2003;38:613-630.
84. Koike AK, Unutzer J, Wells KB. Improving the care
for depression in patients with comorbid medical illness.
Am J Psychiatry. 2002;159:1738-1745.
85. Katon WJ, Roy-Byrne P, Russo J, Cowley D. Cost-effectiveness
and cost offset of a collaborative care intervention for
primary care patients with panic disorder. Arch Gen Psychiatry.
2002;59:1098-1104.
86. Schoenbaum M, Unutzer J, McCaffrey D, Duan N, Sherbourne
C, Wells KB. The effects of primary care depression treatment
on patients' clinical status and employment. Health Serv
Res. 2002;37:1145-1158.
87. Smith JL, Rost KM, Nutting PA, Libby AM, Elliott CE,
Pyne JM. Impact of primary care depression intervention
on employment and workplace conflict outcomes: is value
added? J Ment Health Policy Econ. 2002;5:43-49.
88. Simon GE, Katon W, Rutter C, et al. Impact of improved
depression treatment in primary care on daily functioning
and disabilty. Psychol Med. 1998;28:693-701.
89. Mintz J, Mintz LI, Arruda MJ, Hwang SS. Treatments
of depression and the functional capacity to work. Arch
Gen Psychiatry. 1992;49:761-768.
90. Woods SW, Baker CB. Cost-effectiveness of the newer
generation of antidepressants. In: Davis K, Charney D,
Coyle J, Nemeroff C, eds. Neuropsychopharmacology: The
Fifth Generation of Progress. Philadelphia, PA: American
College of Neuropsychopharmacology; 2002:1119-1137.
91. Simon GE, Katon WJ, VonKorff M, et al. Cost-effectiveness
of a collaborative care program for primary care patients
with persistent depression. Am J Psychiatry. 2001;158:1638-1644.
92. Coulehan JL, Schulberg HC, Block MR, Madonia MJ, Rodriguez
E. Treating depressed primary care patients improves their
physical, mental, and social functioning. Arch Intern
Med. 1997;157:1113-1120.
93. Lave JR, Frank RG, Schulberg HC, Kamlet MS. Cost-effectiveness
of treatments for major depression in primary care practice.
Arch Gen Psychiatry. 1998;55:645-651.
94. Wang PS, Beck AL, Berglund P, et al. Effects of major
depression on moment-in-time work performance. Am J Psychiatry.
2004;161:1885-1891.
95. Kessler RC, Barber CB, Birnbaum HG, et al. Depression
in the workplace: effects on short-term work disability.
Health Aff. 1999;18:163-171.
96. Burner ST, Waldo DR, McKusick DR. National health
expenditures projections through 2030. Health Care Financ
Rev. 1992;14:1-29.
97. Weinstein MC, Fineberg HV. Clinical Decision Analysis.
Philadelphia, PA: Saunders, W. B.; 1980.
98. Kessler RC, Walters EE. The National Comorbidity Survey.
In: Tsaung MT, Tohen M, eds. Textbook in Psychiatric Epidemiology.
2nd ed. New York: John Wiley & Sons; 2002:343-362.
99. Wang PS, Beck AL, McKenas DK, et al. Effects of efforts
to increase response rates on a workplace chronic condition
screening survey. Med Care. 2002;40:752-760.
100. Miranda J, Gonzalez JJ. Research on reducing burden
of affective disorders for special populations: introduction
and general recommendation. Ment Health Serv Res. 2002;4:223-224.
101. Klinkman MS. Competing demands in psychosocial care.
A model for the identification and treatment of depressive
disorders in primary care. Gen Hosp Psychiatry. 1997;19:98-111.
102. Williams JBW. Competing demands: does care for depression
fit in primary care? J Gen Intern Med. 1998;13:137-139.
103. Crofton C, Lubalin JS, Darby C. Consumer Assessment
of Health Plans Study (CAHPS). Foreword. Med Care. 1999;37:MS1-9.
104. National Committee for Quality Assurance. HEDIS 3.0:
Narrative - What's in It and Why It Matters. Vol 1. Annapolis
Junction, MD: National Committee for Quality Assurance;
1997.
105. Ford DE, Pincus HA, Unutzer J, Bauer MS, Gonzalez
JJ, Wells KB. Practice-based interventions. Ment Health
Serv Res. 2002;4:199-204.
106. Wells KB, Miranda J, Bauer MS, et al. Overcoming
barriers to reducing the burden of affective disorders.
Biol Psychiatry. 2002;52:655-675.
107. Pincus HA, Hough L, Houtsinger JK, Rollman BL, Frank
RG. Emerging models of depression care: multi-level ('6
P') strategies. Int J Methods Psychiatr Res. 2003;12:54-63.
108. Bruce ML, Smith W, Miranda J, Hoagwood K, Wells KB.
Community-based interventions. Ment Health Serv Res. 2002;4:205-214.
109. Scheffler R, Durham M, McGuire T, Wells KB. Policy
intervention. Ment Health Serv Res. 2002;4:215-222. |
