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Measures of mental health and addictions conditions show a U-shaped relationship with self-rated worker performance

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Abstract

Background

Reports of a meaningful relationship between mental health-related conditions and work productivity measures are relatively common. These, however, are frequently examined for their linearity while ignoring untapped, and potentially rich, non-linear associations.

Methods

Following a serendipitous finding of a curvilinear relationship between workplace presenteeism (lowered productivity while at work) and depression, an investigation was undertaken of the association between worklife prevalence measures of presenteeism (measured by the W.H.O. Health & Work Performance Questionnaire) and lifetime prevalence of twelve psychosocial vulnerabilities, encompassing mental health, mental health-related, and addictive conditions. Linear and quadratic (U-shaped) functions were calculated across the “relative” presenteeism measure (self vs. other workers) for each of the 12 conditions.

Results

A visual analysis revealed a U-shaped graphic function in all conditions, and excepting anxiety all were statistically significant. In general, increases beyond the lowest (“poorest”) level of self-reported comparative productivity were associated with increases in psychosocial stability, but only as far as deemed equality. Beyond that, increases in self-confidence resulted in a reversal, thus returning to a higher level of vulnerability for the condition in question. A cursory scan of five relevant journals indicated that non-linear analyses were often possible, but rarely carried out.

Conclusions

This has informative value for our conceptualization of overconfidence, and it begs the question of whether an over-reliance on linear measures has caused us to overlook important curvilinear human relationships. The inclusion of analyses of non-linear functions is suggested as a matter of course for future studies.

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Availability of data and material

The original database and the questionnaire have been provided to researchers and policy makers upon request.

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Funding

The study that produced the database in use here was funded by a contract from the Alberta (Canada) Alcohol & Drug Abuse Commission, payable to the Institute of Health Economics (Edmonton, Canada).

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Authors and Affiliations

  1. Institute of Health Economics, 1200, 10405 Jasper Avenue, Edmonton, AB, T5J 3N4, Canada

    Angus H. Thompson

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  1. Angus H. Thompson
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Correspondence to Angus H. Thompson.

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Conflict of interest

The corresponding author states that there is no conflict of interest associated with this paper.

Ethics approval

The study that produced the database in use here was approved by the Health Research Ethics Board of the Faculty of Medicine and Dentistry, University of Alberta.

Consent to participate

In the study that produced the database in use here, respondents were interviewed by telephone (random dialing). It was explained that taking the survey is a personal choice, that names will not be taken, that information will be kept confidential and anonymous, that any question can be skipped- or the interview can be stopped at any time without negative consequences, and that the data collected will be stored in a locked site at the Institute of Health Economics and kept for at least 5 years. Furthermore, respondents were offered contact information for (1) mental health services (2) the project director, and (3) Health Research Ethics Board.

No prior publication

This work has not been published before (neither in English nor in any other language) and that it is not under consideration for publication elsewhere.

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Thompson, A.H. Measures of mental health and addictions conditions show a U-shaped relationship with self-rated worker performance. Soc Psychiatry Psychiatr Epidemiol 56, 1823–1833 (2021). https://doi.org/10.1007/s00127-020-01894-w

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  • DOI: https://doi.org/10.1007/s00127-020-01894-w

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