How important is work environment in understanding the association between depression/anxiety and lost productivity?

Abstract

Purpose: Numerous studies have demonstrated an association of depression and (to a lesser extent) anxiety with lost productivity/work disability, but less is known about the nature of this association. This study applies an environmental model of disability to investigate the role of work-related environmental factors in the association between depression and anxiety and lost productivity. Methods: 436 call centre employees from 10 organisations completed a self-report survey assessing current DSM-IV depressive and anxiety symptoms (Patient Health Questionnaire), work disability (absent days, presenteeism-days at work ill, Work Limitations Questionnaire), and psychosocial work environment (Effort-Reward Imbalance, Organisational Justice). Six-month follow-up surveys have been collected and 12-month follow-up is underway. Results: Lost productivity was common in this sample of call centre employees, with half absent at least one day in the prior month, half coming in to work while unwell on at least one day, and limitations in various work abilities for around 15% of the time. Ten percent reported a depressive or anxiety condition: probable major or minor depression, panic symptoms, or generalized anxiety symptoms. Persons with depression/ anxiety (versus not) were more than twice as likely to report absenteeism and four times as likely to attend work while unwell, and were limited in work ability for 20% of the time. After adjusting for work-related environmental factors, these parameters were reduced by around 10% and 16% for absenteeism and presenteeism, respectively. These findings will be discussed in the light of preliminary data from the 6-month follow-up surveys. Conclusions:Work-related environmental factors are a non-trivial correlate of work disability. Clinical interventions to reduce the impact of mental disorders in the workplace may need to be supplemented with public health interventions targeting psychosocial aspects of the workplace.