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The day-to-day disability of depression
Depression is a clinically heterogeneous condition, with a widely underestimated variety of symptoms spanning emotional, physical and cognitive domains.1,2 Dysfunction across domains of cognition in depression can contribute to wider functional impairments in daily life.3 In fact, depression is ranked as the leading cause of disability worldwide, and is also a major contributor to the global burden of disease.4 Functional disability in daily activities is one of the most important consequences of depression, yet it is also one of the least well understood.3
Depression can increase both absenteeism and presenteeism in the workplace.5
Depression impacts people in the workplace, increasing both presenteeism (loss of productivity due to attendance despite illness) and absenteeism (failure to attend work due to illness), which in severe cases can result in cessation of employment.5 Abilities to maintain household responsibilities and manage finances can also decline, in addition to a reduction in the quantity and quality of social relationships and community ties.3
The impact of cognition on depressive course
The cognitive symptoms of depression also affects the course of a patient’s condition, and has been associated with earlier onset of depression, longer episode duration and increased risk of relapse.3,6–8 The link between cognitive symptoms and risk of relapse is of particular importance, with one study showing that more than 75% of patients with residual cognitive symptoms relapsed within 10 months of achieving ‘remission’.9 This, coupled with the functional impact of depression, creates a cyclic association between onset of symptoms, functional impairment, and relapse:10–19