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Treatment-resistant depression and labor market affiliation in the Danish welfare society: a register-based study

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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.

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Data availability

All data were retrieved from the Danish Health Data Authority and Statistics Denmark. Access to data is ongoing. Admission to data can be obtained after approval by the Danish Data Protection Agency and Statistics Denmark.

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Funding

This study was funded by the Danish Council for Independent Research (grant ID: DFF-6110-00195). The funding source was not involved in the conduct of research or the preparation of the present manuscript.

Author information

Authors and Affiliations

  1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Nordre Fasanvej 57, building 14, entrance 5, 2000, Frederiksberg, Denmark

    Frederikke Hørdam Gronemann & Merete Osler

  2. Unit of Social Medicine, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark

    Thomas Lund

  3. Department of Public Health, University of Copenhagen, Copenhagen, Denmark

    Thomas Lund

  4. Department of Public Health, Aarhus University, Aarhus, Denmark

    Louise Lindholdt

  5. National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark

    Kathrine Bang Madsen

  6. iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Copenhagen, Denmark

    Kathrine Bang Madsen & Merete Nordentoft

  7. Psychiatric Centre Copenhagen, Copenhagen, Denmark

    Martin Balslev Jørgensen & Merete Nordentoft

  8. Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Martin Balslev Jørgensen

  9. Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

    Merete Osler

Authors
  1. Frederikke Hørdam Gronemann
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  4. Kathrine Bang Madsen
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  7. Merete Osler
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Contributions

All listed authors contributed to the design and planning of this study. Collection of and access to data was obtained by MO, MN, and MBJ. Data management and data analyses were performed by FHG with support from LL, TL, and MO. FHG drafted the article. All co-authors contributed to data interpretation, critical revision and final approval of the manuscript.

Corresponding author

Correspondence to Frederikke Hørdam Gronemann.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This study was approved by the Danish data protection authorities. According to Danish law, ethical approval and informed consent are not required for register-based studies.

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Gronemann, F.H., Lund, T., Lindholdt, L. et al. Treatment-resistant depression and labor market affiliation in the Danish welfare society: a register-based study. Soc Psychiatry Psychiatr Epidemiol 57, 1189–1199 (2022). https://doi.org/10.1007/s00127-022-02243-9

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  • DOI: https://doi.org/10.1007/s00127-022-02243-9

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