Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Eur J Public Health. 2019 Dec 1;29(6):1055-1062. doi: 10.1093/eurpub/ckz046.
The aims were to elucidate if trajectories of labour market marginalization (LMM), measured as sickness absence (SA)/disability pension (DP) or unemployment, differed between young immigrants and natives before and after an incident diagnosis of a common mental disorder (CMD), and to investigate if educational level, psychiatric comorbidity and duration of residence in Sweden (in immigrants) had different associations with subsequent LMM in natives compared with immigrants.
A total of 28 971 young adults (19-30 years), with an incident CMD (inpatient or specialized outpatient healthcare due to CMDs or dispensed prescribed antidepressants during 2007) were included. Group-based trajectory models were utilized to identify trajectories of annual months of LMM 3 years before and 6 years after the diagnosis. The associations of risk factors with different trajectories were investigated by multinomial logistic regression, χ2-test and Nagelkerke R2 to measure the associations' strength. Immigrants were categorized into Western and non-Western immigrants.
Young natives and immigrants showed similar trajectories of SA/DP. A higher proportion of non-Western immigrants (20.5%) followed trajectories of high levels of unemployment (>2 annual months) compared with Western immigrants (15%) and natives (16.5%). Educational level and duration of residence in Sweden (in immigrants) discriminated trajectories of both SA/DP and unemployment, whereas psychiatric comorbidity only discriminated trajectories of SA/DP.
Differences in trajectories of unemployment between young natives and immigrants with an incident CMD were found. Educational level and psychiatric comorbidity provided information on differences between natives and immigrants and duration of residence gave information for subgroups of immigrants.
本研究旨在阐明在经历常见精神障碍（CMD）发病事件前后，劳动力市场边缘化（LMM）轨迹（以病假/残疾抚恤金（DP）或失业衡量）在年轻移民和本地人之间是否存在差异，以及教育程度、合并精神疾病和在瑞典的居住时间（在移民中）与随后的 LMM 在本地人中相比与移民的相关性是否存在差异。
共纳入 28971 名年轻成年人（19-30 岁），他们患有 CMD（因 CMD 住院或专门门诊治疗，或在此期间开具处方抗抑郁药）。采用基于群组的轨迹模型来确定发病前 3 年和发病后 6 年 LMM 的年度月份轨迹。通过多变量逻辑回归、χ2检验和 Nagelkerke R2 来调查风险因素与不同轨迹之间的关联，以衡量关联的强度。移民分为西方移民和非西方移民。
年轻的本地人和移民表现出相似的病假/DP 轨迹。与西方移民（15%）和本地人（16.5%）相比，非西方移民（20.5%）失业水平较高（>2 个年度月）的比例更高。教育程度和在瑞典的居住时间（在移民中）区分了病假/DP 和失业的轨迹，而合并精神疾病仅区分了病假/DP 的轨迹。
在患有 CMD 的年轻本地人和移民中发现了失业轨迹的差异。教育程度和合并精神疾病提供了本地人和移民之间差异的信息，而在瑞典的居住时间则为移民的亚组提供了信息。
