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Associations between unemployment and major depressive disorder: Evidence from an international, prospective study (the predict cohort)

Author

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  • Jefferis, Barbara J.
  • Nazareth, Irwin
  • Marston, Louise
  • Moreno-Kustner, Berta
  • Bellón, Juan Ángel
  • Svab, Igor
  • Rotar, Danica
  • Geerlings, Mirjam I.
  • Xavier, Miguel
  • Goncalves-Pereira, Manuel
  • Vicente, Benjamin
  • Saldivia, Sandra
  • Aluoja, Anu
  • Kalda, Ruth
  • King, Michael

Abstract

Unemployment is known to be associated with poor mental health, but it is not clear how strongly unemployment leads to onset of diagnosed clinical depression (causation), or if depression raises the risks of becoming unemployed (health selection), or indeed if both pathways operate. We therefore investigate the direction of associations between clinical depression and unemployment in a cross-cultural prospective cohort study. 10,059 consecutive general practice attendees (18–75 years) were recruited from six European countries and Chile between 2003 and 2004 and followed up at six, 12 and (in a subset) 24 months. The analysis sample was restricted to 3969 men and women who were employed or unemployed and seeking employment and had data on depression measures. The outcomes were depressive episodes, assessed using the Depression Section of the Composite International Diagnostic Interview (CIDI) and self-reported employment status. Among 3969 men and women with complete data on depression and unemployment, 10% (n = 393) had depression symptoms and a further 6% (n = 221) had major depression at 12 months. 11% (n = 423) of the sample were unemployed by 6 months. Participants who became unemployed between baseline and 6 months compared to those employed at both times had an adjusted relative risk ratio for 12-month depression of 1.58 (95% Confidence Interval 0.76, 3.27). Participants with depression at baseline and 6 months compared to neither time had an odds ratio for 6-month unemployment of 1.58 (95% Confidence Interval 0.97, 2.58). We found evidence that causation and (to a lesser extent) health selection raise the prevalence of depression in the unemployed. Unemployed adults are at particular risk for onset of major clinical depression and should be offered extra services or screened. Given the trend for adults with depression to perhaps be at greater risk of subsequent unemployment, employees with depressive symptoms should also be supported at work as a precautionary principle.

Suggested Citation

  • Jefferis, Barbara J. & Nazareth, Irwin & Marston, Louise & Moreno-Kustner, Berta & Bellón, Juan Ángel & Svab, Igor & Rotar, Danica & Geerlings, Mirjam I. & Xavier, Miguel & Goncalves-Pereira, Manuel &, 2011. "Associations between unemployment and major depressive disorder: Evidence from an international, prospective study (the predict cohort)," Social Science & Medicine, Elsevier, vol. 73(11), pages 1627-1634.
    • Handle: RePEc:eee:socmed:v:73:y:2011:i:11:p:1627-1634
    DOI: 10.1016/j.socscimed.2011.09.029
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    References listed on IDEAS

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    1. Morrell, S. & Taylor, R. & Quine, S. & Kerr, C. & Western, J., 1994. "A cohort study of unemployment as a cause of psychological disturbance in Australian youth," Social Science & Medicine, Elsevier, vol. 38(11), pages 1553-1564, June.
    2. Graetz, Brian, 1993. "Health consequences of employment and unemployment: Longitudinal evidence for young men and women," Social Science & Medicine, Elsevier, vol. 36(6), pages 715-724, March.
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    1. Taina Leinonen & Netta Mäki & Pekka Martikainen, 2017. "Trajectories of Antidepressant Medication before and after the Onset of Unemployment by Subsequent Employment Experience," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-16, January.
    2. Daniel Sage, 2015. "Do Active Labour Market Policies Promote the Well-Being, Health and Social Capital of the Unemployed? Evidence from the UK," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 124(2), pages 319-337, November.
    3. Bijlsma, Maarten J. & Tarkiainen, Lasse & Myrskylä, Mikko & Martikainen, Pekka, 2017. "Unemployment and subsequent depression: A mediation analysis using the parametric G-formula," Social Science & Medicine, Elsevier, vol. 194(C), pages 142-150.
    4. Kamerāde, Daiga & Wang, Senhu & Burchell, Brendan & Balderson, Sarah Ursula & Coutts, Adam, 2019. "A shorter working week for everyone: How much paid work is needed for mental health and well-being?," Social Science & Medicine, Elsevier, vol. 241(C).
    5. Daiga KamerÄ de & Matthew R Bennett, 2018. "Rewarding Work: Cross-National Differences in Benefits, Volunteering During Unemployment, Well-Being and Mental Health," Work, Employment & Society, British Sociological Association, vol. 32(1), pages 38-56, February.
    6. Bubonya, Melisa & Cobb-Clark, Deborah A. & Ribar, David C., 2017. "The Bilateral Relationship between Depressive Symptoms and Employment Status," IZA Discussion Papers 10653, Institute of Labor Economics (IZA).
    7. Daniel Sage, 2015. "Do Active Labour Market Policies Promote the Subjective Well-Being of the Unemployed? Evidence from the UK National Well-Being Programme," Journal of Happiness Studies, Springer, vol. 16(5), pages 1281-1298, October.
    8. Bubonya, Melisa & Cobb-Clark, Deborah A. & Ribar, David C., 2019. "The reciprocal relationship between depressive symptoms and employment status," Economics & Human Biology, Elsevier, vol. 35(C), pages 96-106.
    9. Bijlsma, Maarten & Tarkiainen, Lasse & Myrskylä, Mikko & Martikainen, Pekka, 2017. "Unemployment and subsequent depression: A mediation analysis using the parametric G-formula," LSE Research Online Documents on Economics 85335, London School of Economics and Political Science, LSE Library.

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