Depression, Disability Days, and Days Lost From Work in a Prospective Epidemiologic Survey

TLDR

The study aims to examine how depression and depressive symptoms relate to disability days and work loss over one year in 2980 North Carolina participants. Data were collected from the Epidemiologic Catchment Area Study, following participants for one year to assess depression status and subsequent disability and work loss. Major depression increased disability risk 4.78‑fold (95% CI 1.64–13.88), minor depression increased risk 1.55‑fold (95% CI 1.00–2.40) and contributed 51% more disability days than major depression; minor depression also raised the likelihood of anxiety or progression to major depression within a year, suggesting the need to broaden diagnostic thresholds to address depression’s societal impact.

Abstract

We describe the relationship of depression and depressive symptoms to disability days and days lost from work in 2980 participants in the Epidemiologic Catchment Area Study in North Carolina after 1 year of follow-up. Compared with asymptomatic individuals, persons with major depression had a 4.78 times greater risk of disability (95% confidence interval, 1.64 to 13.88), and persons with minor depression with mood disturbance, but not major depression, had a 1.55 times greater risk (95% confidence interval, 1.00 to 2.40). Because of its prevalence, individuals with minor depression were associated with 51% more disability days in the community than persons with major depression. This group was also at increased risk of having a concomitant anxiety disorder or developing major depression within 1 year. We conclude that the threshold for identifying clinically significant depression may need to be reevaluated to include persons with fewer symptoms but measurable morbidity. Only by changing our nosology can the societal impact of depression be adequately addressed.