This paper presents an overview of the World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) and a discussion of the methodological research on which the development of the instrument was based. The WMH-CIDI includes a screening module and 40 sections that focus on diagnoses (22 sections), functioning (four sections), treatment (two sections), risk factors (four sections), socio-demographic correlates (seven sections), and methodological factors (two sections). Innovations compared to earlier versions of the CIDI include expansion of the diagnostic sections, a focus on 12-month as well as lifetime disorders in the same interview, detailed assessment of clinical severity, and inclusion of information on treatment, risk factors, and consequences. A computer-assisted version of the interview is available along with a direct data entry software system that can be used to keypunch responses to the paper-and-pencil version of the interview. Computer programs that generate diagnoses are also available based on both ICD-10 and DSM-IV criteria. Elaborate CD-ROM-based training materials are available to teach interviewers how to administer the interview as well as to teach supervisors how to monitor the quality of data collection.

/pdf/the-world-mental-health-wmh-survey-initiative-version-of-the-2n6nicodkz.pdf

The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI).

ContextEvidence consistently indicates that depression has adversely affected
work productivity. Estimates of the cost impact in lost labor time in the
US workforce, however, are scarce and dated.ObjectiveTo estimate the impact of depression on labor costs (ie, work absence
and reduced performance while at work) in the US workforce.Design, Setting, and ParticipantsAll employed individuals who participated in the American Productivity
Audit (conducted August 1, 2001–July 31, 2002) between May 20 and July
11, 2002, were eligible for the Depressive Disorders Study. Those who responded
affirmatively to 2 depression-screening questions (n = 692), as well as a
1:4 stratified random sample of those responding in the negative (n = 435),
were recruited for and completed a supplemental interview using the Primary
Care Evaluation of Mental Disorders Mood Module for depression, the Somatic
Symptom Inventory, and a medical and treatment history for depression. Excess
lost productive time (LPT) costs from depression were derived as the difference
in LPT among individuals with depression minus the expected LPT in the absence
of depression projected to the US workforce.Main Outcome MeasureEstimated LPT and associated labor costs (work absence and reduced performance
while at work) due to depression.ResultsWorkers with depression reported significantly more total health-related
LPT than those without depression (mean, 5.6 h/wk vs an expected 1.5 h/wk,
respectively). Eighty-one percent of the LPT costs are explained by reduced
performance while at work. Major depression accounts for 48% of the LPT among
those with depression, again with a majority of the cost explained by reduced
performance while at work. Self-reported use of antidepressants in the previous
12 months among those with depression was low (<30%) and the mean reported
treatment effectiveness was only moderate. Extrapolation of these survey results
and self-reported annual incomes to the population of US workers suggests
that US workers with depression employed in the previous week cost employers
an estimated $44 billion per year in LPT, an excess of $31 billion per year
compared with peers without depression. This estimate does not include labor
costs associated with short- and long-term disability.ConclusionsA majority of the LPT costs that employers face from employee depression
is invisible and explained by reduced performance while at work. Use of treatments
for depression appears to be relatively low. The combined LPT burden among
those with depression and the low level of treatment suggests that there may
be cost-effective opportunities for improving depression-related outcomes
in the US workforce.

https://jamanetwork.com/journals/jama/articlepdf/196767/joc30290.pdf

Cost of lost productive work time among US workers with depression.

Evidence about the total cost of health, absence, short-term disability, and productivity losses was synthesized for 10 health conditions. Cost estimates from a large medical/absence database were combined with findings from several published productivity surveys. Ranges of condition prevalence and associated absenteeism and presenteeism (on-the-job-productivity) losses were used to estimate condition-related costs. Based on average impairment and prevalence estimates, the overall economic burden of illness was highest for hypertension ($392 per eligible employee per year), heart disease ($368), depression and other mental illnesses ($348), and arthritis ($327). Presenteeism costs were higher than medical costs in most cases, and represented 18% to 60% of all costs for the 10 conditions. Caution is advised when interpreting any particular source of data, and the need for standardization in future research is noted.

/pdf/health-absence-disability-and-presenteeism-cost-estimates-of-54br5s3wmi.pdf

Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers.

This report describes the World Health Organization Health and Work Performance Questionnaire (HPQ), a self-report instrument designed to estimate the workplace costs of health problems in terms of reduced job performance, sickness absence, and work-related accidents-injuries. Calibration data are presented on the relationship between individual-level HPQ reports and archival measures of work performance and absenteeism obtained from employer archives in four groups: airline reservation agents (n = 441), customer service representatives (n = 505), automobile company executives (n = 554), and railroad engineers (n = 850). Good concordance is found between the HPQ and the archival measures in all four occupations. The paper closes with a brief discussion of the calibration methodology used to monetize HPQ reports and of future directions in substantive research based on the HPQ.

The World Health Organization Health and Work Performance Questionnaire (HPQ).

Attention Bias Modification Treatment: A Meta-Analysis Toward the Establishment of Novel Treatment for Anxiety

This article discusses the impact of depression on work productivity and the potential for improved work performance associated with effective treatment. We undertook a review of the literature by means of a computer search using the following key terms: cost of illness, work loss, sickness absence, productivity, performance, and disability. Published works were considered in four categories: (1) naturalistic cross-sectional studies that found greater self-reported work impairment among depressed workers; (2) naturalistic longitudinal studies that found a synchrony of change between depression and work impairment; (3) uncontrolled treatment studies that found reduced work impairment with successful treatment; and (4) controlled trials that usually, but not always, found greater reduction in work impairment among treated patients. Observational data suggest that productivity gains following effective depression treatment could far exceed direct treatment costs. Randomized effectiveness trials are needed before we can conclude definitively that depression treatment results in productivity improvements sufficient to offset direct treatment costs.

Phillip Wang

Papers

The World Health Organization Health and Work Performance Questionnaire (HPQ).

Depression and work productivity: the comparative costs of treatment versus nontreatment.

World Health Organization Health and Work Performance Questionnaire