A community study of depression treatment and employment earnings

Objective: Although treatment for major depression has been shown to reduce the costs of lost earnings resulting from lost work days, research has not demonstrated whether the reduction fully offsets time costs of treatment f or the disorder. Methods: A statewide cohort of community residents with re cent major depression, dysthymia, or substantial depressive symptoms was re cruited and interviewed at baseline and at six-month and 12-month follow-up s. The cost of lost earnings was measured by lost work days multiplied by s ubjects' wage rates. Cost of treatment for depression was approximated usin g charges abstracted from provider and insurance records. Net economic cost , defined as the sum of changes in lost earnings and depression treatment c osts, was examined in multiple regression analyses. Results: After the anal yses controlled for sociodemographic characteristics, baseline severity of depression, and comorbidity, no statistically significant effect of depress ion treatment on net economic cost was found. This finding suggests that th e cost of depression treatment was fully offset by savings from reduction i n lost work days. Results from sensitivity analyses in multiple alternative scenarios support the same conclusion. Conclusions: The finding of a full offset of depression treatment cost is conservative because other benefits, such as reduced pain and suffering and increased productivity while at wor k, were not included in the analyses. Employers who bear the cost from lost work days should encourage their employees with depressive disorders td se ek treatment, even if it means paying for the entire treatment cost. Self-e mployed individuals with depression also will benefit even if they pay for the treatment costs themselves.