Prospective evaluation of the effect of major depression on working status in a population sample

Abstract

Objective: Numerous surveys have reported associations between major depressive episodes (MDEs) and occupational status, but cross-sectional studies cannot quantify the risks of employment transitions nor clarify their temporal direction. The goal of our study was to estimate the impact of MDE on subsequent employment status in a longitudinal community cohort. Methods: Data from the National Population Health Survey (NPHS) were used. Proportional hazard models and logistic regression were employed to evaluate the effect of MDE on working status during the 1994 to 2004 interval among respondents who reported working at a job or business at baseline. Results: MDE was associated with an increased risk of movement to nonworking status. People aged 26 to 45 years with MDEs have more than double the risk of this transition (HR = 2.6; 95% CI 1.8 to 3.6, P < 0.001). The probability of transition to nonworking status was higher, but the relative effect was smaller in people aged 46 to 65 years (HR = 1.2; 95% CI 0.7 to 2.0, P = 0.47). Retirement or perceived lack of availability of work did not contribute to the association. Conclusions: MDE is associated with an elevated risk of transition from working to nonworking status, especially in people aged 26 to 45 years.