Department of Psychological Medicine,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK.
Department of Social Policy,The London School of Economics and Political Science,London,UK.
Epidemiol Psychiatr Sci. 2019 Feb;28(1):88-99. doi: 10.1017/S2045796017000403. Epub 2017 Aug 24.
Associations between employment status and mental health are well recognised, but evidence is sparse on the relationship between paid employment and mental health in the years running up to statutory retirement ages using robust mental health measures. In addition, there has been no investigation into the stability over time in this relationship: an important consideration if survey findings are used to inform future policy. The aim of this study is to investigate the association between employment status and common mental disorder (CMD) in 50-64-year old residents in England and its stability over time, taking advantage of three national mental health surveys carried out over a 14-year period.
Data were analysed from the British National Surveys of Psychiatric Morbidity of 1993, 2000 and 2007. Paid employment status was the primary exposure of interest and CMD the primary outcome - both ascertained identically in all three surveys (CMD from the revised Clinical Interview Schedule). Multivariable logistic regression models were used.
The prevalence of CMD was higher in people not in paid employment across all survey years; however, this association was only present for non-employment related to poor health as an outcome and was not apparent in those citing other reasons for non-employment. Odds ratios for the association between non-employment due to ill health and CMD were 3.05 in 1993, 3.56 in 2000, and 2.80 in 2007, after adjustment for age, gender, marital status, education, social class, housing tenure, financial difficulties, smoking status, recent physical health consultation and activities of daily living impairment.
The prevalence of CMD was higher in people not in paid employment for health reasons, but was not associated with non-employment for other reasons. Associations had been relatively stable in strength from 1993 to 2007 in those three cross-sectional nationally representative samples.
就业状况与心理健康之间的关联已得到广泛认可，但使用可靠的心理健康测量方法，在达到法定退休年龄之前的几年中，有关有偿就业与心理健康之间关系的证据却很少。此外，对于这种关系随时间的稳定性，尚未进行调查：如果要使用调查结果为未来的政策提供信息，这是一个重要的考虑因素。本研究旨在利用在 14 年期间进行的三项全国性心理健康调查，调查英格兰 50-64 岁居民的就业状况与常见精神障碍（CMD）之间的关联及其随时间的稳定性。
分析了 1993 年、2000 年和 2007 年进行的英国全国精神疾病发病率调查的数据。有偿就业状况是主要的暴露因素，CMD 是主要的结果-在所有三项调查中均以相同的方式确定（CMD 来自修订后的临床访谈时间表）。使用多变量逻辑回归模型。
在所有调查年份中，非有偿就业者的 CMD 患病率均较高；但是，这种关联仅存在于非就业与健康不良作为结果有关的情况下，而在因其他原因失业的情况下则不明显。1993 年，2000 年和 2007 年，由于健康状况不佳而导致的非就业与 CMD 之间的关联的优势比分别为 3.05、3.56 和 2.80，调整后为年龄，性别，婚姻状况，教育程度，社会阶层，住房所有权，经济困难，吸烟状况，最近的身体健康咨询和日常生活活动障碍。
由于健康原因而没有从事有偿工作的人患有 CMD 的患病率较高，但与其他原因的非就业无关。在这三个具有代表性的横断面样本中，从 1993 年到 2007 年，关联的强度相对稳定。
