Article Text

Download PDFPDF

Is manager support related to workplace productivity for people with depression: a secondary analysis of a cross-sectional survey from 15 countries
  1. Sara Evans-Lacko,
  2. Martin Knapp
  1. Personal Social Services, Research Unit, London School of Economics and Political Science, London, UK
  1. Correspondence to Dr Sara Evans-Lacko; s.evans-lacko{at}


Objectives To examine variations in manager reactions and support for people with depression and to investigate how these reactions are related to (1) absenteeism and (2) presenteeism due to depression among employees with self-reported depression across 15 diverse countries.

Design Secondary data analysis of cross-sectional survey data.

Setting 15 countries, diverse in geographical region and gross domestic product (GDP): Brazil, Canada, China, Denmark, France, Germany, Great Britain, Italy, Japan, Mexico, Spain, South Africa, South Korea, Turkey and the USA.

Participants 16 018 employees and managers (approximately 1000 per country).

Primary and secondary outcome measures We assessed level of absenteeism as measured by number of days taken off work because of depression and presenteeism score.

Results On average, living in a country with a greater prevalence of managers saying that they avoided talking to the employee about depression was associated with employees with depression taking more days off work (B 4.13, 95% CI 1.68 to 6.57). On average, living in a country with a higher GDP was marginally associated with employees with depression taking more days off of work (p=0.09). On average, living in a country with a greater prevalence of managers actively offering help to employees with depression was associated with higher levels of presenteeism (B 7.08, 95% CI 6.59 to 7.58). Higher country GDP was associated with greater presenteeism among employees with depression (B 3.09, 95% CI 2.31 to 3.88).

Conclusions Manager reactions were at least as important as country financial resources. When controlling for country GDP, working in an environment where managers felt comfortable to offer help and support to the employee rather than avoid them was independently associated with less absenteeism and more presenteeism.

  • mental health
  • public health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors The original study design and protocol were written by SE-L and MK. SE-L performed data analysis and initial drafting of the manuscript with contributions from MK. Both authors participated in the interpretation of the analysis, editing and rewriting of the manuscript and approved the final manuscript.

  • Funding Funding for this study was provided by H Lundbeck A/S. H Lundbeck A/S put together the questionnaire with the European Depression Association.

  • Competing interests SE-L and MK received consulting fees from H Lundbeck A/S.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional unpublished data are available.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.