PURPOSE: Depressed employees are vulnerable to adverse work outcomes. We 
hypothesized that work performance is impaired by depression and is worsened by 
exposure to psychosocial work stressors.
DESIGN: Longitudinal cohort study with surveys administered at baseline, 6, 12, 
and 18 months.
SETTING: Recruitment in primary care offices.
SUBJECTS: A total of 14,268 were screened; 286 depressed, employed adults (18-62 
years) and 193 controls were enrolled.
MEASURES: At-work limitations (presenteeism) and absenteeism were measured with 
the Work Limitations Questionnaire (WLQ) and WLQ Work Absence Module, 
respectively. Work stressors were assessed using a modified version of the Job 
Content Questionnaire.
ANALYSIS: Univariate and multivariate tests assessed the degree to which at-work 
limitations were related to depression and/or stressful work.
RESULTS: Presenteeism and absenteeism were significantly worse for the 
depression group at each time point (p < or = .001). In cross-sectional models, 
presenteeism was associated with more severe depression symptoms, poorer general 
physical health, psychologically demanding work, the interaction 
ofpsychologically demanding work with depression, and less job control (r2 range 
= .33-.54). Absences were explained by depression symptom severity and poorer 
general physical health but not work stressors (r2 = .19). Because of minimal 
change in the work stressors, their longitudinal effects on outcomes were mostly 
nonsignificant.
CONCLUSION: This study found that depression symptoms are related to work 
absences and impaired work performance, and results partly confirmed that work 
stressors add to this impact. Results suggest that workers with depression may 
benefit from care involving medical and vocational interventions.