Adolescent depression and adult labor market marginalization: a longitudinal cohort study

Abstract

Adolescent depression is linked to adult ill-health and functional impairment, but recent research suggests that individual/contextual factors might account for this association. This study aimed to test whether the clinical heterogeneity of adolescent depression is related to marginalization from the labor market across early to middle adulthood. Data were drawn from the Uppsala Longitudinal Adolescent Depression Study, a community-based cohort initially assessed with structured clinical interviews at age 16–17. The cohort (n = 321 depressed; n = 218 nondepressed) was followed up after 2+ decades through linkage to nationwide population-based registries. Outcomes included consecutive annual data on unemployment, work disability, social welfare recipiency, and a composite marginalization measure, spanning from age 21 to 40. Longitudinal associations were examined using logistic regression analysis in a generalized estimating equations modeling framework. Subsequent depressive episodes and educational attainment in early adulthood were explored as potential pathways. The results showed that adolescent depression was associated with adult marginalization outcomes, but the strength of association varied across depressed subgroups. Adolescents with persistent depressive disorder had higher odds of all outcomes, including the composite marginalization measure (adjusted OR = 2.0, 95% CI = 1.4–2.7, p < 0.001), and this was partially (31%) mediated by subsequent depressive episodes in early adulthood. Exploratory moderation analysis revealed that entry into tertiary education mitigated the association with later marginalization, but only for adolescents with episodic major depression. In conclusion, the risk for future labor market marginalization is elevated among depressed adolescents, particularly those presenting with persistent depressive disorder. Targeted interventions seem crucial to mitigate the long-lasting impact of early-onset depression.

Sickness absence among young employees in private and public sectors with a history of depression and anxiety

“…Several mental disorders with onset in adolescence, including depression and anxiety, are denoted by continuity into adulthood 14 – 16 , which suggest that mental disorders may last for a long period and affect functioning in adulthood. Previous studies report on increased risk for disadvantageous outcomes in adulthood including health, economy, and labor market participation 17 – 20 among those with a history of depression and/or anxiety in adolescence. Findings from a few studies on mental disorders in adolescence and future SA suggest that depressive and anxiety symptoms in early life years tend to increase the risk for SA later in adulthood 21 , 22 .…”

Associations of Internalizing and Externalizing Problems in Childhood and Adolescence With Adult Labor Market Marginalization

“…Consistent with prior research, we defined adult LMM as 2 outcomes, long-term unemployment and work disability, during the follow-up from 2006 to 2018. Long-term unemployment (recorded as a binary outcome) was operationalized as 180 or more annual net days of being registered as full-time or part-time unemployed or included in labor market policy programs.…”

“…While previous genetically informative studies reporting on the association of youth mental health problems with adulthood LMM suggest that unmeasured familial confounding is highly relevant, important knowledge gaps remain to be addressed. First, in terms of duration, there is a need to tease apart the course of mental health problems across childhood and adolescence in relation to LMM, notably as studies suggest persistent cases fare worse than episodic cases . This poorer long-term prognosis for persistent cases is observed for both internalizing and externalizing problems, and applies to those assessed with structured clinical interviews or self-report questionnaires.…”

“…First, in terms of duration, there is a need to tease apart the course of mental health problems across childhood and adolescence in relation to LMM, notably as studies suggest persistent cases fare worse than episodic cases. [27][28][29][30][31][32] This poorer long-term prognosis for persistent cases is observed for both internalizing [27][28][29] and externalizing problems, 30,31 and applies to those assessed with structured clinical interviews or selfreport questionnaires. Next, in terms of timing, it still remains unclear if the onset of mental health problems in childhood or adolescence is more harmful to adult health and functioning, as current evidence is limited and inconsistent.…”

Nature-Based Meditation, Rumination and Mental Wellbeing

“…In addition, common mental health difficulties such as depression and anxiety may have been rising over the past decade [ 9 ], despite the efforts of evidence-based treatments [ 10 ]. The psychosocial sequelae of mental health difficulties and low wellbeing are many [ 11 ] and include recurrence of mental ill health [ 12 ], increased risk of failure to complete secondary education [ 13 ], labour market marginalisation [ 14 ] and somatic illness [ 15 ]. Furthermore, there are huge economic costs attached to mental health difficulties [ 16 ].…”