Depressive symptoms as a predictor of 5-year subsequent work nonparticipation due to long-term sickness absence, unemployment and early retirement in a cohort of 2,413 employees in Germany

Abstract

Abstract Background: We examined the impact of depressive symptoms on events – and duration thereof – of work nonparticipation (long-term sickness absence, unemployment, early retirement). Methods: We used a 5-year cohort of the Study on Mental Health at Work (S-MGA) based on a random sample of employees subject to social contributions aged 31–60 years in 2012 (N =2413). Depressive symptoms were assessed at baseline through questionnaires, while employment history was recorded in follow-up interviews. Effects of depressive symptoms on work nonparticipation were examined in two-part models, with events analysed by logistic regressions and their duration by generalized linear models (GLMs). Results: Medium to severe depressive symptoms increased the risk of events of work nonparticipation (males OR=3.22, 95% CI=1.90–5.45; females OR: 1.92, 1.29–2.87), particularly events of long-term sickness absence in both genders and events of unemployment among males. Mild depressive symptoms increased the risk of events of work nonparticipation (males OR=1.59, 1.19–2.11; females OR = 1.42, 1.10–1.84). Among those experiencing one or more events, the duration of total work nonparticipation was twice as high among males [EXP(B) =2.06; 95% CI: 1.53–2.78] and about one third higher [EXP(B) =1.38; 95% CI: 1.05–1.83] among females with medium to severe depressive symptoms. Conclusions: The present study takes into account the occurrence of work nonparticipation but also its duration, which are both critical for assessing societal consequences of depressive symptoms. It is important to consider mild depressive symptoms and examine several types of work nonparticipation.