Bipolar disorder and depression in early adulthood and long-term employment, income, and educational attainment: A nationwide cohort study of 2,390,127 individuals.


Journal

Depression and anxiety
ISSN: 1520-6394
Titre abrégé: Depress Anxiety
Pays: United States
ID NLM: 9708816

Informations de publication

Date de publication:
11 2019
Historique:
received: 11 03 2019
revised: 22 08 2019
accepted: 22 08 2019
pubmed: 12 9 2019
medline: 15 4 2020
entrez: 12 9 2019
Statut: ppublish

Résumé

Mood disorders are known to be associated with poor socioeconomic outcomes, but no study has examined these associations across the entire worklife course. Our goal was to estimate the associations between bipolar disorder and depression in early adulthood and subsequent employment, income, and educational attainment. We conducted a nationwide prospective cohort study including all individuals (n = 2,390,127; 49% female) born in Denmark between 1955 and 1990. Hospital-based diagnoses of depression and bipolar disorder before age 25 were obtained from the Danish psychiatric register. Yearly employment, earnings, and education status from ages 25 to 61 were obtained from the Danish labor market and education registers. We estimated both absolute and relative proportions. Population rates of hospital-diagnosed depression and bipolar between ages 15-25 were 1% and 0.12%, respectively. Compared to individuals without mood disorders, those with depression and particularly bipolar disorder had consistently poor socioeconomic outcomes across the entire work-life span. For example, at age 30, 62% of bipolar and 53% of depression cases were outside the workforce compared to 19% of the general population, and 52% of bipolar and 42% of depression cases had no higher education compared to 27% of the general population. Overall, individuals with bipolar disorder or depression earned around 36% and 51%, respectively, of the income earned by individuals without mood disorders. All associations were smaller for individuals not rehospitalized after age 25. Severe mood disorders with onset before age 25, particularly bipolar disorder, are associated with persistent poor socioeconomic outcomes across the entire work-life course.

Sections du résumé

BACKGROUND
Mood disorders are known to be associated with poor socioeconomic outcomes, but no study has examined these associations across the entire worklife course. Our goal was to estimate the associations between bipolar disorder and depression in early adulthood and subsequent employment, income, and educational attainment.
METHODS
We conducted a nationwide prospective cohort study including all individuals (n = 2,390,127; 49% female) born in Denmark between 1955 and 1990. Hospital-based diagnoses of depression and bipolar disorder before age 25 were obtained from the Danish psychiatric register. Yearly employment, earnings, and education status from ages 25 to 61 were obtained from the Danish labor market and education registers. We estimated both absolute and relative proportions.
RESULTS
Population rates of hospital-diagnosed depression and bipolar between ages 15-25 were 1% and 0.12%, respectively. Compared to individuals without mood disorders, those with depression and particularly bipolar disorder had consistently poor socioeconomic outcomes across the entire work-life span. For example, at age 30, 62% of bipolar and 53% of depression cases were outside the workforce compared to 19% of the general population, and 52% of bipolar and 42% of depression cases had no higher education compared to 27% of the general population. Overall, individuals with bipolar disorder or depression earned around 36% and 51%, respectively, of the income earned by individuals without mood disorders. All associations were smaller for individuals not rehospitalized after age 25.
CONCLUSIONS
Severe mood disorders with onset before age 25, particularly bipolar disorder, are associated with persistent poor socioeconomic outcomes across the entire work-life course.

Identifiants

pubmed: 31508865
doi: 10.1002/da.22956
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1080-1088

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Auteurs

Christian Hakulinen (C)

Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus University, Aarhus, Denmark.
NCRR-National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.
CIRRAU-Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark.

Katherine L Musliner (KL)

iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus University, Aarhus, Denmark.
NCRR-National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.
CIRRAU-Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark.

Esben Agerbo (E)

iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus University, Aarhus, Denmark.
NCRR-National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.
CIRRAU-Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark.

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