Mental disorders and long‐term labour market outcomes: nationwide cohort study of 2 055 720 individuals

Hakulinen, Christian; Elovainio, Marko; Arffman, Martti; Lumme, Sonja; Pirkola, Sami; Keskimäki, Ilmo; Manderbacka, Kristiina; Böckerman, Petri

doi:10.1111/acps.13067

Cited by 119 publications

(111 citation statements)

References 51 publications

(69 reference statements)

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“…Mental illness predicts worse labor market outcomes later in life. After a diagnosis of depression or anxiety, employment rates and incomes have been estimated to fall by as much as half, relative to the nondepressed or nonanxious (70,71). Beyond such comparisons, which may be driven in part by unknown factors such as physical health, there is little evidence from natural experiments to link depression or anxiety to incomes.…”

Section: The Causal Impact Of Mental Ill-health On Povertymentioning

confidence: 99%

Poverty, depression, and anxiety: Causal evidence and mechanisms

Ridley

Rao

Schilbach

et al. 2020

Science

543

326

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Why are people who live in poverty disproportionately affected by mental illness? We review the interdisciplinary evidence of the bidirectional causal relationship between poverty and common mental illnesses—depression and anxiety—and the underlying mechanisms. Research shows that mental illness reduces employment and therefore income, and that psychological interventions generate economic gains. Similarly, negative economic shocks cause mental illness, and antipoverty programs such as cash transfers improve mental health. A crucial step toward the design of effective policies is to better understand the mechanisms underlying these causal effects.

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Section: The Causal Impact Of Mental Ill-health On Povertymentioning

confidence: 99%

Poverty, depression, and anxiety: Causal evidence and mechanisms

Ridley

Rao

Schilbach

et al. 2020

Science

543

326

View full text Add to dashboard Cite

show abstract

“…There was evidence that people with psychiatric disorders earned much lesser than those without mental disorders ( 44 – 46 ). A study in Finland also showed that more than half of the people with schizophrenia at working age did not have earning or earned very little ( 47 ). Full-timer in sales/services sectors who worked longer hour (51.14 hours, SD=12.49) constituted a large proportion of the employed sample, which may explain the longer average hours worked in our sample.…”

Section: Discussionmentioning

confidence: 99%

Vocational Profile and Correlates of Employment in People With Schizophrenia: The Role of Avolition

2020

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Objective: Employment was associated with recovery in individuals with schizophrenia. Our study aimed to delineate the vocational profile and investigate factors associated with likelihood of employment in individuals with schizophrenia. Materials and Methods: 276 community dwelling outpatients with schizophrenia were recruited; 274 completed the Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptom Scale (BNSS). Information on employment status, work outcomes and demographics were collected. Occupation was coded in accordance with the Singapore standard occupational classification. Either BNSS Motivation and Pleasure (MAP) and Emotional Expressivity (EE) or BNSS five-factor (Anhedonia, Asociality, Avolition, Blunted Affect, Alogia) were examined with PANSS factors and demographics in logistic regression with employment status and working full-time as outcome variables. Results: One-hundred and twenty-seven (46.01%) participants were employed; 65 (51.18%) worked full-time. In the model with BNSS MAP-EE, MAP (OR=0.897, CI=0.854-0.941) and presence of physical comorbidity (OR=0.533, CI=0.304-0.937) were associated with reduced likelihood of employment; female sex (OR=0.286, CI=0.128-0.637) was associated with working part-time. In the model with BNSS fivefactor, Avolition (OR=0.541, CI=0.440-0.666), and PANSS Positive (OR=0.924, CI=0.855-0.997) were associated with reduced likelihood of employment; female sex (OR=0.289, CI=0.126-0.662) and Avolition (OR=0.644, CI=0.475-0.872) were associated with working part-time. Discussion: Our study described the vocational profile and correlates of employment in a developed urban Asian country. Negative symptoms, particularly MAP and Avolition, positive symptoms, and physical comorbidity reduced an individual's likelihood of employment, while female sex and Avolition were associated with working part-time. Efforts to identify and address these factors are necessary to encourage employment in individuals with schizophrenia.

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“…Two scenarios have been suggested: 1) low childhood SES or poor school results predicts problematic drinking behaviors in adulthood, and 2) drinking problems during adolescence/young adulthood predicts lower educational level and lower SES in adulthood [8, 22]. For example, a recent study from Finland showed that alcohol abuse in adolescence/ early adulthood was associated with unemployment, lower income and lower educational level [28]. It is also possible that a set of familial factors predispose to both low SES and risk for AUD with no causal relationship between them.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic status and alcohol use disorders across the lifespan: A co-relative control study

Calling

Sundquist

et al. 2019

PLoS ONE

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ObjectivesAlcohol use disorders (AUD) is well known to aggregate in families and is associated with socioeconomic status (SES). The objective was to study the effect of education, income and neighborhood SES in adulthood on AUD, and to explore whether the potential associations were confounded by shared familial factors, by using a co-relative control design.MethodsData on AUD was drawn from the Swedish inpatient and outpatient care registers; prescription drug register; and crime data. Through national population registers we collected information on income, education and neighborhood SES at age 25, 30, 35 and 40 years in all individuals born in Sweden between 1950 and 1980. Each sex-specific stratum consisted of approximately 750,000–1,200,000 individuals, who were followed for AUD for a mean follow-up time ranging between 10 and 15 years until the end of 2013. Cox proportional hazards models were used to investigate the risk of AUD as a function of income, education and neighborhood SES in the general population and in pairs of first cousins and full siblings within the same sex, who differed in their exposure to the SES measure.ResultsHigher educational level, higher income and higher neighborhood SES were all associated with a reduced risk for AUD for both males and females in all ages. The potentially protective effect remained but was attenuated when comparing pairs of first cousins and full siblings.ConclusionsHigh educational level and income in adulthood, as well as high neighborhood socioeconomic status, may represent protective factors against alcohol use disorders, even when shared familial factors, e.g. childhood socioeconomic status and genetic factors, have been taken into account.

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Mental disorders and long‐term labour market outcomes: nationwide cohort study of 2 055 720 individuals

Cited by 119 publications

References 51 publications

Poverty, depression, and anxiety: Causal evidence and mechanisms

Poverty, depression, and anxiety: Causal evidence and mechanisms

Vocational Profile and Correlates of Employment in People With Schizophrenia: The Role of Avolition

Socioeconomic status and alcohol use disorders across the lifespan: A co-relative control study

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