OBJECTIVE: The relationship of depressive symptoms, satisfaction with health 
care, and 2-year work outcomes was examined in a national cohort of employees.
METHOD: A total of 6,239 employees of three corporations completed surveys on 
health and satisfaction with health care in 1993 and 1995. This study used 
bivariate and multivariate analyses to examine the relationships of depressive 
symptoms (a score below 43 on the Medical Outcomes Study Short-Form Health 
Survey mental component summary), satisfaction with a variety of dimensions of 
health care in 1993, and work outcomes (sick days and decreased effectiveness in 
the workplace) in 1995.
RESULTS: The odds of missed work due to health problems in 1995 were twice as 
high for employees with depressive symptoms in both 1993 and 1995 as for those 
without depressive symptoms in either year. The odds of decreased effectiveness 
at work in 1995 was seven times as high. Among individuals with depressive 
symptoms in 1993, a report of one or more problems with clinical care in 1993 
predicted a 34% increase in the odds of persistent depressive symptoms and a 66% 
increased odds of decreased effectiveness at work in 1995. There was a weaker 
association between problems with plan administration and outcomes.
CONCLUSIONS: Depressive disorders in the workplace persist over time and have a 
major effect on work performance, most notably on "presenteeism," or reduced 
effectiveness in the workplace. The study's findings suggest a potentially 
important link between consumers' perceptions of clinical care and work outcomes 
in this population.