Young adults with a history of depression and/or anxiety: the role of sociodemographic and health-related factors in not being sickness absent

Abstract

Objectives: The continuity of mental health problems from childhood to adulthood is well acknowledged, as is the impact on work ability. However, knowledge is scarce about individuals who maintain work ability and have no sickness absence (SA), despite mental health problems. The aim was to identify sociodemographic and health-related factors among private and public employees with a history of depression and/or anxiety, and no SA.

Methods: This prospective cohort study included 9039 Swedish twin individuals born between 1975 and 1986, with and without a history of depression and/or anxiety, and employed in the private or public sectors. Survey data from 2005 were used to classify self-rated depression, anxiety, and overall health. Data on SA, education, occupational class, outpatient health care use, and prescribed antidepressants were obtained from national registries. Participants were prospectively followed for SA from 2006 to 2020. Logistic regression analyses were applied to calculate odds ratios (ORs) with 95% CIs.

Results: Approximately 37% of individuals with previous depression and/or anxiety were not on SA during follow-up, compared with 54% of those without such history. Lower use of antidepressants implied higher odds for no SA among both private (OR: 2.09; 95% CI, 1.64-2.66) and public (OR: 2.38; 95% CI, 1.78-3.19) employees with previous depression and/or anxiety. Having fewer visits to outpatient health care was significantly associated with no SA (ORs: 2.22-3.60). Being a white-collar worker implied higher odds for no SA only among those privately employed (OR: 1.39; 95% CI, 1.10-1.76).

Conclusions: Primarily, health-related factors seemed to play a role in no SA among young employees with previous depression and/or anxiety.