The association between mental disorders and subsequent years of working life: a Danish population-based cohort study.


Journal

The lancet. Psychiatry
ISSN: 2215-0374
Titre abrégé: Lancet Psychiatry
Pays: England
ID NLM: 101638123

Informations de publication

Date de publication:
01 2023
Historique:
received: 15 06 2022
revised: 23 09 2022
accepted: 27 10 2022
pubmed: 9 12 2022
medline: 21 12 2022
entrez: 8 12 2022
Statut: ppublish

Résumé

Mental disorders can affect workforce participation via a range of mechanisms. In this study, we aimed to estimate the association between different types of mental disorders and working years lost, defined as the number of years not actively working or enrolled in an educational programme. In this population-based cohort study, we included all people aged 18-65 years (mean 38·0 [SD 13·9]) in the Danish Civil Registration System from Jan 1, 1995 to Dec 31, 2016. Information on mental disorders was obtained from the Danish Psychiatric Central Research Register and information on labour market characteristics was obtained from administrative registers. Follow-up started at age 18 years, immigration to Denmark, or on Jan 1, 1995, whichever came later; and it ended at age 65 years, death, emigration from Denmark, disability pension, voluntary early retirement, or Dec 31, 2016 (whichever came earlier). As the main outcome, we estimated working years lost for those diagnosed with any mental disorder and 24 types of mental disorders, as well as for the general population of same age and sex. We decomposed total working years lost into periods of unemployment or sick leave, disability pension, voluntary early retirement, or death. Data on ethnicity were not available through administrative registers. A total of 5 163 321 individuals, 2 642 383 men and 2 520 938 women, were followed up for 65·4 million person-years. Overall, 488 775 (9·47%) individuals were diagnosed with a mental disorder. On average, individuals with mental disorders lost an additional 10·52 (95% CI 10·48-10·57) years of working life compared with the general Danish population. Receiving a disability pension (7·54 [7·49-7·59] years) and longer periods of unemployment (2·24 [2·21-2·27] years) accounted for most of this difference. Our findings foreground the substantial impact of mental disorders on workforce participation. There is a need to invest in programmes that reduce the burden of working years lost and assist people with mental disorders in returning to the workforce. Lundbeck Foundation and Danish National Research Foundation.

Sections du résumé

BACKGROUND
Mental disorders can affect workforce participation via a range of mechanisms. In this study, we aimed to estimate the association between different types of mental disorders and working years lost, defined as the number of years not actively working or enrolled in an educational programme.
METHODS
In this population-based cohort study, we included all people aged 18-65 years (mean 38·0 [SD 13·9]) in the Danish Civil Registration System from Jan 1, 1995 to Dec 31, 2016. Information on mental disorders was obtained from the Danish Psychiatric Central Research Register and information on labour market characteristics was obtained from administrative registers. Follow-up started at age 18 years, immigration to Denmark, or on Jan 1, 1995, whichever came later; and it ended at age 65 years, death, emigration from Denmark, disability pension, voluntary early retirement, or Dec 31, 2016 (whichever came earlier). As the main outcome, we estimated working years lost for those diagnosed with any mental disorder and 24 types of mental disorders, as well as for the general population of same age and sex. We decomposed total working years lost into periods of unemployment or sick leave, disability pension, voluntary early retirement, or death. Data on ethnicity were not available through administrative registers.
FINDINGS
A total of 5 163 321 individuals, 2 642 383 men and 2 520 938 women, were followed up for 65·4 million person-years. Overall, 488 775 (9·47%) individuals were diagnosed with a mental disorder. On average, individuals with mental disorders lost an additional 10·52 (95% CI 10·48-10·57) years of working life compared with the general Danish population. Receiving a disability pension (7·54 [7·49-7·59] years) and longer periods of unemployment (2·24 [2·21-2·27] years) accounted for most of this difference.
INTERPRETATION
Our findings foreground the substantial impact of mental disorders on workforce participation. There is a need to invest in programmes that reduce the burden of working years lost and assist people with mental disorders in returning to the workforce.
FUNDING
Lundbeck Foundation and Danish National Research Foundation.

Identifiants

pubmed: 36480953
pii: S2215-0366(22)00376-5
doi: 10.1016/S2215-0366(22)00376-5
pii:
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

30-39

Informations de copyright

Copyright © 2023 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of interests The authors declare no competing interests.

Auteurs

Oleguer Plana-Ripoll (O)

Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; National Centre for Register-based Research, Aarhus University, Aarhus, Denmark. Electronic address: opr@clin.au.dk.

Nanna Weye (N)

Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.

Ann Kristin Knudsen (AK)

Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.

Christian Hakulinen (C)

Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland; Welfare State Research and Reform, Finnish Institute for Health and Welfare, Helsinki, Finland.

Kathrine Bang Madsen (KB)

National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.

Maria Klitgaard Christensen (MK)

National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark.

Esben Agerbo (E)

National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.

Thomas Munk Laursen (TM)

National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.

Merete Nordentoft (M)

The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Copenhagen Research Centre for Mental Health, Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.

Allan Timmermann (A)

National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.

Harvey Whiteford (H)

Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, QLD, Australia; School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Simon Øverland (S)

Section for Health Care Collaboration, Haukeland University Hospital, Bergen, Norway.

Kim Moesgaard Iburg (KM)

Department of Public Health, Aarhus University, Aarhus, Denmark.

John J McGrath (JJ)

National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, QLD, Australia; Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia.

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