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Trajectories of work disability and unemployment among young adults with common mental disorders
Karolinska Institutet.
The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.ORCID iD: 0000-0001-6138-6427
Karolinska Institutet.
Karolinska Institutet.
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2018 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 18, article id 1228Article in journal (Refereed) Published
Abstract [en]

BackgroundLabour-market marginalisation (LMM) and common mental disorders (CMDs) are serious societal problems. The aims were to describe trajectories of LMM (both work disability and unemployment) among young adults with and without CMDs, and to elucidate the characteristics associated with these trajectories.MethodsThe study was based on Swedish registers and consisted of all individuals 19-30years with an incident diagnosis of a CMD in year 2007 (n=7245), and a matched comparison group of individuals without mental disorders during the years 2004-07 (n=7245). Group-based trajectory models were used to describe patterns of LMM both before, and after the incident diagnosis of a CMD. Multinomial logistic regressions investigated the associations between sociodemographic and medical covariates and the identified trajectories.ResultsTwenty-six percent (n=1859) of young adults with CMDs followed trajectories of increasing or constant high levels of work disability, and 32 % (n=2302) followed trajectories of increasing or constant high unemployment. In the comparison group, just 9 % (n=665) followed increasing or constant high levels of work disability and 21 % (n=1528) followed trajectories of increasing or constant high levels of unemployment. A lower share of young adults with CMDs followed trajectories of constant low levels of work disability (n=4546, 63%) or unemployment (n=2745, 38%), compared to the level of constant low work disability (n=6158, 85%) and unemployment (n=3385, 50%) in the comparison group. Remaining trajectories were fluctuating or decreasing. Around 50% of young adults with CMDs had persistent levels of LMM at the end of follow-up. The multinomial logistic regression revealed that educational level and comorbid mental disorders discriminated trajectories of work disability, while educational level, living area and age determined differences in trajectories of unemployment (R-difference(2)=0.02-0.05, p<0.001).ConclusionsA large share, nearly 50%, of young adults with CMDs, substantially higher than in the comparison group of individuals without mental disorders, display increasing or high persistent levels of either work disability or unemployment throughout the follow-up period. Low educational level, comorbidity with other mental disorders and living in rural areas were factors that increased the probability for LMM.

Place, publisher, year, edition, pages
BioMed Central, 2018. Vol. 18, article id 1228
Keywords [en]
Sick leave, Disability pension, Unemployment, Common mental disorders, Labour market marginalisation, Education
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:rkh:diva-2733DOI: 10.1186/s12889-018-6141-yPubMedID: 30400785OAI: oai:DiVA.org:rkh-2733DiVA, id: diva2:1265124
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015–00742Available from: 2018-11-22 Created: 2018-11-22 Last updated: 2023-08-28Bibliographically approved

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Tinghög, PetterSaboonchi, Fredrik

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