Wang Philip S, Beck Arne L, Berglund Pat, McKenas David K, Pronk Nicolaas P, Simon Gregory E, Kessler Ronald C
Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA.
Am J Psychiatry. 2004 Oct;161(10):1885-91. doi: 10.1176/ajp.161.10.1885.
Although major depression is thought to have substantial negative effects on work performance, the possibility of recall bias limits self-report studies of these effects. The authors used the experience sampling method to address this problem by collecting comparative data on moment-in-time work performance among service workers who were depressed and those who were not depressed.
The group studied included 105 airline reservation agents and 181 telephone customer service representatives selected from a larger baseline sample; depressed workers were deliberately oversampled. Respondents were given pagers and experience sampling method diaries for each day of the study. A computerized autodialer paged respondents at random time points. When paged, respondents reported on their work performance in the diary. Moment-in-time work performance was assessed at five random times each day over a 7-day data collection period (35 data points for each respondent).
Seven conditions (allergies, arthritis, back pain, headaches, high blood pressure, asthma, and major depression) occurred often enough in this group of respondents to be studied. Major depression was the only condition significantly related to decrements in both of the dimensions of work performance assessed in the diaries: task focus and productivity. These effects were equivalent to approximately 2.3 days absent because of sickness per depressed worker per month of being depressed.
Previous studies based on days missed from work significantly underestimate the adverse economic effects associated with depression. Productivity losses related to depression appear to exceed the costs of effective treatment.
尽管重度抑郁症被认为会对工作表现产生重大负面影响，但回忆偏差的可能性限制了关于这些影响的自我报告研究。作者采用经验抽样法来解决这一问题，通过收集抑郁和未抑郁服务工作者即时工作表现的对比数据。
研究组包括从更大的基线样本中选取的105名航空公司预订员和181名电话客服代表；抑郁的员工被刻意过度抽样。在研究的每一天，给受访者配备传呼机和经验抽样法日记。一个电脑自动拨号器在随机时间点呼叫受访者。被呼叫时，受访者在日记中报告他们的工作表现。在为期7天的数据收集期内，每天随机5次评估即时工作表现（每位受访者35个数据点）。
在这组受访者中，七种情况（过敏、关节炎、背痛、头痛、高血压、哮喘和重度抑郁症）出现得足够频繁，可进行研究。重度抑郁症是唯一与日记中评估的工作表现的两个维度（任务专注度和生产力）下降显著相关的情况。这些影响相当于每位抑郁员工每月因抑郁而因病缺勤约2.3天。
以往基于缺勤天数的研究显著低估了与抑郁症相关的不利经济影响。与抑郁症相关的生产力损失似乎超过了有效治疗的成本。
