Hospitalisation for depressive disorder following unemployment--differentials by gender and immigrant status: a population-based cohort study in Sweden

J Epidemiol Community Health. 2013 Oct;67(10):875-81. doi: 10.1136/jech-2013-202701. Epub 2013 Jul 18.

Abstract

Background: The association between unemployment and poor mental health in general is explained by both causation and selection. The aim was to study whether experiencing unemployment was a risk factor for hospitalisation for depressive disorder specifically, and whether gender and immigrant status modified the hypothesised risk.

Methods: A register-based prospective cohort study, 2000-2006, of persons aged 18-64 with a strong connection to the Swedish labour market.

Outcome: hospital admission for a depressive episode; F32 in International Classification of Diseases, 10th revision.

Exposure: employment status. Explanatory variables: gender and immigrant status. Confounders: age group, education and marital status. Cox regression models were used to estimate HRs with 95% CIs.

Results: The cohort comprised 3 284 896 adults, 47.5% women. An excess relative risk for hospitalisation was found among those who became unemployed (HR=1.94, 95% CI 1.85 to 2.03). Foreign-born women who experienced unemployment had the highest relative risk (HR=3.47 95% CI 3.02 to 3.98).

Conclusions: Among persons with a strong connection to the labour market experiencing unemployment, is a risk factor for hospitalisation for depressive disorders. Unemployed foreign-born women had the highest relative risk compared with all Swedish born, all foreign-born men and to employed foreign-born women.

Keywords: DEPRESSION; GENDER; LONGITUDINAL STUDIES; MIGRATION; UNEMPLOYMENT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology*
  • Emigrants and Immigrants / psychology*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Socioeconomic Factors
  • Sweden / epidemiology
  • Unemployment / psychology*