Emotional disability days: Prevalence and predictors

Department of Mental Hygiene, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md 21205.
American Journal of Public Health (Impact Factor: 4.55). 09/1994; 84(8):1304-7. DOI: 10.2105/AJPH.84.8.1304
Source: PubMed


This study considered days missed from work or usual activities for emotional reasons associated with a range of specific psychopathologic disorders, psychosocial distress, and persons found to be asymptomatic. Analyses were performed with the presence or absence of emotional disability days as the dependent variable using logistic regression. The effects of specific mental disorders were compared with the effects of chronic physical conditions for labor force participants and for the total population. The odds ratio (and 95% confidence interval) for subjects with major depressive disorder was 27.8 (6.93, 108.96); for panic disorder, 21.1 (2.25, 198.44); and for schizophrenia, 17.8 (1.73, 182.99). Work-place adjustments for persons with psychopathology are encouraged.

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Available from: Anthony C Kouzis,
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    • "Depression is a common reason for receiving disability benefits [10], [11], [12], incurring more costs for long-term disability (LTD) than other disorders [13]. Individuals suffering from psychiatric disorders who are also receiving disability benefits require more complex treatment and have more difficulty returning to work than those suffering from other disabling complaints [14]. "
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    ABSTRACT: Depression is the most frequent reason for receiving disability benefits in North America, and treatment with psychotherapy is often funded by private insurers. No studies have explored the association between the provision of psychotherapy for depression and time to claim closure. Using administrative data from a Canadian disability insurer, we evaluated the association between the provision of psychotherapy and short-term disability (STD) and long-term disability (LTD) claim closure by performing Cox proportional hazards regression. We analyzed 10,508 STD and 10,338 LTD claims for depression. In our adjusted analyses, receipt of psychotherapy was associated with longer time to STD closure (HR [99% CI] = 0.81 [0.68 to 0.97]) and faster LTD claim closure (1.42 [1.33 to 1.52]). In both STD and LTD, older age (0.90 [0.88 to 0.92] and 0.83 [0.80 to 0.85]), per decade), a primary diagnosis of recurrent depression versus non-recurrent major depression (0.78 [0.69 to 0.87] and 0.80 [0.72 to 0.89]), a psychological secondary diagnosis (0.90 [0.84 to 0.97] and 0.66 [0.61 to 0.71]), or a non-psychological secondary diagnosis (0.81 [0.73 to 0.90] and 0.77 [0.71 to 0.83]) versus no secondary diagnosis, and an administrative services only policy ([0.94 [0.88 to 1.00] and 0.87 [0.75 to 0.996]) or refund policy (0.86 [0.80 to 0.92] and 0.73 [0.68 to 0.78]) compared to non-refund policy claims were independently associated with longer time to STD claim closure. We found, paradoxically, that receipt of psychotherapy was independently associated with longer time to STD claim closure and faster LTD claim closure in patients with depression. We also found multiple factors that were predictive of time to both STD and LTD claim closure. Our study has limitations, and well-designed prospective studies are needed to establish the effect of psychotherapy on disabling depression.
    PLoS ONE 10/2013; 8(6):e67162. DOI:10.1371/journal.pone.0067162 · 3.23 Impact Factor
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    • "MDD contributes 4.4% of the total disability-adjusted life years (Murray and Lopez, 1996; Ustun et al., 2004) and is associated with substantial personal, economic, and social burden (Kessler et al., 2003). For example, individuals with MDD are approximately 28 times more likely to miss workdays or usual activities because of emotional reasons (Kouzis and Eaton, 1994). Despite the high prevalence and burden of MDD, only approximately 60% of individuals receive treatment (Kessler et al., 2003), making it an important public health challenge . "
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    ABSTRACT: The current study examined demographic and psychosocial factors that predict major depressive disorder (MDD) and comorbid MDD/posttraumatic stress disorder (MDD/PTSD) diagnostic status after Hurricane Katrina, one of the deadliest and costliest hurricanes in the history of the United States. This study expanded on the findings published in the article by Galea, Tracy, Norris, and Coffey (J Trauma Stress 21:357-368, 2008), which examined the same predictors for PTSD, to better understand related and unique predictors of MDD, PTSD, and MDD/PTSD comorbidity. A total of 810 individuals representative of adult residents living in the 23 southernmost counties of Mississippi before Hurricane Katrina were interviewed. Ongoing hurricane-related stressors, low social support, and hurricane-related financial loss were common predictors of MDD, PTSD, and MDD/PTSD, whereas educational and marital status emerged as unique predictors of MDD. Implications for postdisaster relief efforts that address the risk for both MDD and PTSD are discussed.
    The Journal of nervous and mental disease 10/2013; 201(10):841-847. DOI:10.1097/NMD.0b013e3182a430a0 · 1.69 Impact Factor
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    • "Panic disorder has a negative impact on well-being and on health perception (Katerndahl & Realini, 1997 ; Klerman et al. 1991), and is associated with impaired functioning (Kessler et al. 2006 ; Wittchen et al. 1998) and absence from work (Alonso et al. 2004 ; Kouzis & Eaton, 1994, 1997). In addition, panic disorder may be associated with suicidal ideation and/or attempts (Cougle et al. 2009 ; Goodwin & Roy-Byrne, 2006 ; Lepine et al. 1993 ; Weissman et al. 1989), even if the impact of comorbid disorders on this association is a matter of debate (Hornig & McNally, 1995) and although the evidence that panic disorder causes suicidality remains unclear (Sareen et al. 2005a). "
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    ABSTRACT: The evidence-based pharmacotherapy of panic disorder continues to evolve. This paper reviews data on first-line pharmacotherapy, evidence for maintenance treatment, and management options for treatment-refractory patients. A Medline search of research on pharmacotherapy was undertaken, and a previous systematic review on the evidence-based pharmacotherapy of panic disorder was updated. Selective serotonin reuptake inhibitors remain a first-line pharmacotherapy of panic disorder, with the serotonin noradrenaline reuptake inhibitor venlafaxine also an acceptable early option. Temporary co-administration of benzodiazepines can be considered. Maintenance treatment reduces relapse rates, but further research to determine optimal duration is needed. For patients not responding to first-line agents several pharmacotherapy options are available, but there is a notable paucity of data on the optimal choice.
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