The direct and indirect costs of employee depression, anxiety, and emotional disorders--an employer case study

J Occup Environ Med. 2009 May;51(5):564-77. doi: 10.1097/JOM.0b013e3181a1f5c8.


Objective: To quantify the direct and indirect costs of employee depression, anxiety, and emotional disorders at one large employer in 2004 using administrative data sources.

Methods: Health care claims, personnel, disability, and productivity data were merged at the individual employee level. Direct medical costs were attributed to disease status using Episode Treatment Groups, and indirect costs were attributed using regression models and relative weights.

Results: Depression, anxiety, and emotional disorders were the fifth costliest of all disease categories. The average cost per case was $1646, with 53% coming from indirect costs and 47% from direct costs.

Conclusions: The cost burden of depression, anxiety, and emotional disorders is among the greatest of any disease conditions in the workforce. It is worth considering methods for quantifying direct and indirect costs that use administrative data sources given their utility.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affective Symptoms / economics
  • Anxiety Disorders / economics
  • Cost of Illness*
  • Databases, Factual
  • Depression / economics*
  • Female
  • Health Care Costs*
  • Humans
  • Insurance
  • Male
  • Mental Disorders / economics*
  • Middle Aged
  • Organizational Case Studies
  • Regression Analysis
  • Sick Leave / economics
  • Southeastern United States
  • Young Adult