Frederikke Hørdam Gronemann1, Thomas Lund2,3, Louise Lindholdt4, Kathrine Bang Madsen5,6, Martin Balslev Jørgensen7,8, Merete Nordentoft6,7, Merete Osler9,10. 1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Nordre Fasanvej 57, building 14, entrance 5, 2000, Frederiksberg, Denmark. frederikke.hoerdam@regionh.dk. 2. Unit of Social Medicine, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark. 3. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 4. Department of Public Health, Aarhus University, Aarhus, Denmark. 5. National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark. 6. iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Copenhagen, Denmark. 7. Psychiatric Centre Copenhagen, Copenhagen, Denmark. 8. Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. 9. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Nordre Fasanvej 57, building 14, entrance 5, 2000, Frederiksberg, Denmark. 10. Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Abstract
PURPOSE: We explored if patients with treatment-resistant depression (TRD) go through different states of labor market affiliation during their course of illness before they return to work or obtain early retirement as compared to patients without TRD. METHODS: All adults between 18 and 58 years with a first-time hospital contact due to depression in Danish patients' registers from 2000 to 2014 were followed in a nationwide labor market database. At time of TRD (index week), TRD patients were matched with patients without TRD in a 1:2 ratio. Sequence analysis and logistic regression were applied to explore the association of TRD and labor market affiliation and measures of transitions between labor market states 52 weeks before and after the index week. RESULTS: At the index week, 14.1% of patients with TRD were in employment, whereas the proportion was 26.4% among non-TRD patients. Over time, the proportion of patients in employment increased slightly to 25.5% for TRD and 33.7% for non-TRD patients. The proportion of TRD patients with sickness absence at index was 47.0%, while the proportion was 26.2% for non-TRD patients. The adjusted odds of a below mean volatility of labor market transitions, characterized by more episodes in passive social transfer payments and disability pension, were higher among patients with TRD compared with non-TRD patients (OR 1.63, 95% CI [1.56-1.69]). Similarly, the adjusted odds of a below mean integration into employment were 1.63 higher among TRD patients compared with non-TRD patients (95% CI [1.56-1.70]). CONCLUSION: Patients with TRD have higher levels of sickness absence and lower levels of reintegration into the labor market after meeting the criteria for TRD compared with patients without TRD.
PURPOSE: We explored if patients with treatment-resistant depression (TRD) go through different states of labor market affiliation during their course of illness before they return to work or obtain early retirement as compared to patients without TRD. METHODS: All adults between 18 and 58 years with a first-time hospital contact due to depression in Danish patients' registers from 2000 to 2014 were followed in a nationwide labor market database. At time of TRD (index week), TRD patients were matched with patients without TRD in a 1:2 ratio. Sequence analysis and logistic regression were applied to explore the association of TRD and labor market affiliation and measures of transitions between labor market states 52 weeks before and after the index week. RESULTS: At the index week, 14.1% of patients with TRD were in employment, whereas the proportion was 26.4% among non-TRD patients. Over time, the proportion of patients in employment increased slightly to 25.5% for TRD and 33.7% for non-TRD patients. The proportion of TRD patients with sickness absence at index was 47.0%, while the proportion was 26.2% for non-TRD patients. The adjusted odds of a below mean volatility of labor market transitions, characterized by more episodes in passive social transfer payments and disability pension, were higher among patients with TRD compared with non-TRD patients (OR 1.63, 95% CI [1.56-1.69]). Similarly, the adjusted odds of a below mean integration into employment were 1.63 higher among TRD patients compared with non-TRD patients (95% CI [1.56-1.70]). CONCLUSION: Patients with TRD have higher levels of sickness absence and lower levels of reintegration into the labor market after meeting the criteria for TRD compared with patients without TRD.
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