In Practice

A Practicing Doctor's Views on Psychiatry and Contemporary Culture.

Peter D. Kramer is a psychiatrist and author. His books include Against Depression and Listening to Prozac. See full bio

August 27, 2008, Depression

A Quick Note: It's Depression That Keeps People Off the Job

Depression and time out of work — a quick note

As an addendum to my posting earlier this week on the harm that depressive symptoms cause for patients with bipolar disorder —

Regarding the question of mood and days lost from work: Researchers from the University of Washington in Seattle have just published results from a 2-year-long overview of the employment status of outpatients with bipolar disorder. Depressive symptoms but not mania were significantly associated with time off work. Patients with substantial depressive symptoms missed about a day of work a week more than did patients in remission. That's an enormous difference, representing very substantial impairment. (Patients with manic symptoms missed work, too, but this finding did not meet statistical standards of significance.) The depressed patients were also 15% less likely to be employed. Almost half of the unemployed were experiencing a full depressive episode.

The researchers conclude: "Among patients with bipolar disorder, depression is strongly and consistently associated with decreased probability of employment and more days missed from work due to illness. Symptoms of mania or hypomania have more variable effects on work productivity."

Adding to a large literature on the disabling effects of mood disorders, this study underscores the harm done by depression in particular.

Note: My former Brown colleague Mark Bauer contributed to both this study of employment and the one referenced in my prior post, on subsyndromal symptoms in bipolar disorder.