Occupational factors and labor market outcomes after sickness absence due to common mental disorders

Abstract Aim To investigate how occupational sector, industry, and psychosocial characteristics of the occupation affect labor market outcomes after sickness absence (SA) due to common mental disorders (CMDs). Methods In this nationwide longitudinal register-based cohort study, we included all individuals in Sweden aged 25-55 who began a new SA spell due to a CMD (ICD-10: F32-33, F40-43) lasting more than 30 days in 2011-2013 (n = 79,673). We followed the cohort for up to three years to measure total days of unemployment (UE), SA, and disability pension (DP). Occupational sector and industry were identified using registry data, and psychosocial characteristics of the occupation (job demands, control, and strain) were assessed using the Swedish Job Exposure Matrix. We used multinomial logistic regression to estimate associations between occupational factors and varying UE and SA/DP durations. Results After adjusting for sociodemographic and health-related factors, individuals in the public sector were less likely to have > 180 days of UE (OR = 0.4, 95% CI: 0.3-0.4). Working in the education and public administration or health and social care industries was also associated with a lower likelihood of > 180 days of UE, but a higher likelihood of > 365 days of SA/DP. Contrarily, low control, passive (low control/low demands), and high-strain (low control/high demand) jobs were associated with an increased likelihood of both > 180 days of UE and > 365 days of SA/DP. For > 180 UE days, the ORs were 1.4 (95% CI: 1.3-1.5) for low control, 1.5 (95% CI: 1.4-1.6) for passive, and 1.2 (95% CI: 1.1-1.4) for high-strain jobs. For > 365 SA/DP days, the corresponding ORs were 1.1 (95% CI: 1.1-1.2), 1.1 (95% CI: 1.0-1.2), and 1.2 (95% CI: 1.0-1.3), respectively. Conclusions The associations of occupational factors and long-term SA/DP and UE after SA due to a CMD suggest that improvements in the psychosocial work environment could contribute to preventing long-term labor market exclusion. Key messages • Working in the public sector, education, public administration, and health and social care industries was associated with fewer unemployment days after sickness absence due to common mental disorders. • Low control, passive, and high-strain jobs had a higher likelihood of long-term sickness absence, disability pension, and unemployment after sickness absence due to common mental disorders.