Adolescent depression and subsequent earnings across early to middle adulthood: a 25-year longitudinal cohort study

Abstract

Aims The few available studies on early-onset depression and future earnings offer ambiguous findings, and potential sources of heterogeneity are poorly understood. We examined the differences in adult earnings of males and females with and without a history of depressive disorder in adolescence, with specific focuses on (1) future earnings in clinical subtypes of adolescent depression; (2) the growth and distribution of earnings over time within these subgroups and (3) the mediating role of subsequent depressive episodes occurring in early adulthood. Methods Data were drawn from the Uppsala Longitudinal Adolescent Depression Study, a community-based cohort study initiated in Uppsala, Sweden, in the early 1990s. Comprehensive diagnostic assessments were conducted at age 16–17 and in follow-up interviews 15 years later, while consecutive data on earnings for the years 1996 to 2016 (ages 20–40) were drawn from population-based registries. The current study included participants with a history of persistent depressive disorder (PDD) (n = 175), episodic major depressive disorder (MDD) (n = 82), subthreshold depression (n = 64) or no depression (n = 218) in adolescence. The association of adolescent depression with earnings in adulthood was analysed using generalised estimating equations. Estimates were adjusted for major child and adolescent psychiatric comorbidities and parental socioeconomic status. The indirect (mediated) effect of depression in early adulthood (ages 19–30) on earnings in mid-adulthood (31–40) was estimated in mediation analysis. The study followed the ‘STrengthening the Reporting of OBservational studies in Epidemiology’ (STROBE) guidelines. Results Earnings across early to middle adulthood were lower for participants with a history of a PDD in adolescence than for their non-depressed peers, with an adjusted ratio of mean earnings of 0.85 (0.77–0.95) for females and 0.76 (0.60–0.95) for males. The differences were consistent over time, and more pronounced in the lower percentiles of the earnings distributions. The association was partially mediated by recurrent depression in early adulthood (48% in total; 61% for females, 29% for males). No reduction in earnings was observed among participants with episodic MDD in adolescence, while results for subthreshold depression were inconclusive. Conclusions Our findings suggest that future earnings of adolescents with depressive disorders are contingent on the duration and natural long-term course of early-onset depression, emphasising the need for timely and effective interventions to avoid loss of human capital.

Change in Work-Related Income Following the Uptake of Treatment for Mental Disorders Among Young Migrant Women in Norway: A National Register Study

“…Adjustment for several time-varying background variables such as educational level, marital status and motherhood did not alter this. Our results are in accordance with previous research showing that mental disorders are associated with subsequent income loss [23][24][25][26]. Furthermore, we also found the effect of mental disorders, de ned by OPMH treatment, to vary by income level, with greater adverse effects among women in the low-income group.…”

“…Previous studies have found that mental disorders have a negative impact on several work-related outcomes such as poor labour market attachment [19][20][21][22] and lower earnings, with an income reduction of between 6.5 and 20.0 percent [23][24][25][26]. This loss of income has been explained by reduced productivity or concentration.…”

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

“…More broadly, early exposure to depression or depression symptoms may also interfere with normal development in other important life domains, such as school performance (e.g., GPA) [64] and attainment of tertiary education [3], which are important factors in the context of labor market outcomes [13]. While previous research has indicated that educational attainment [16] and recurring bouts of depression [16,20] may play an intermediate role in determining adult socioeconomic outcome, there has been no study to date addressing the risk of marginalization from the labor market while accounting for various sources of important heterogeneity associated with adolescent depression and its longer-term outcomes. In the present study, we sought to expand on the preliminary evidence pointing to the roles played by both the educational paths taken and the illness course of depression.…”

The timing and duration of depressive symptoms from adolescence to young adulthood and young adults’ NEET status: the role of educational attainment

“…Depressive symptoms affect several labour market outcomes, including NEET status (Neither in Education, Employment nor Training) [1][2][3][4][5][6][7][8][9][10][11][12][13][14], which may be due to a negative effect of depressive symptoms on the level of energy, concentration and motivation [4]. Also, poor labour market participation may affect mental health negatively [6,14].…”