Comparing the effects on work performance of mental and physical disorders

To estimate work loss days due to absenteeism and presenteeism associated with commonly occurring mental and physical disorders.

In a nationally representative face-to-face survey (Netherlands Mental Health Survey and Incidence Study-2) including 4,715
workers, the presence of 13 mental and 10 chronic physical disorders was assessed using the Composite International Diagnostic
Interview 3.0 and a physical disorder checklist. Questions about absent days due to illness and days of reduced quantitative
and qualitative functioning while at work were based on the WHO Disability Assessment Schedule. Total work loss days were
defined as the sum of the days of these three types of loss, where days of reduced functioning were counted as half. Both
individual and population-level effects of disorders on work loss were studied, taking comorbidity into account.

Any mental disorder was associated with 10.5 additional absent days, 8.0 days of reduced-qualitative functioning and 12.0
total work loss days. For any physical disorder, the number of days was 10.7, 3.5 and 11.3, respectively. Adjusted for comorbidity,
drug abuse, bipolar disorder, major depression, digestive disorders and panic disorder were associated with the highest number
of additional total work loss days. At population-level, major depression, chronic back pain, respiratory disorders, drug
abuse and digestive disorders contributed the most. Annual total work loss costs per million workers were estimated at €360
million for any mental disorder; and €706 million for any physical disorder.

Policies designed to lessen the impact of commonly occurring disorders on workers will contribute to a reduction in absenteeism
and presenteeism. As the indirect costs of (mental) disorders are much higher than their medical costs, prevention and treatment
of these conditions may be cost-effective.