University of Toronto, Toronto, Ontario, Canada.
Centers for Disease Control and Prevention, Atlanta, Georgia.
Arthritis Care Res (Hoboken). 2021 Jan;73(1):65-77. doi: 10.1002/acr.24381.
To examine the relationship between depressive symptoms, arthritis, and employment, and to determine whether this relationship differs across young, middle-age, and older working-age adults with arthritis.
Data from the US National Health Interview Survey from 2013-2017 were analyzed. Analyses were restricted to adults with doctor-diagnosed arthritis of working age (ages 18-64 years) with complete data on depressive symptoms (n = 11,380). Covariates were sociodemographic information, health, and health system utilization variables. Employment prevalence was compared by self-reported depressive symptoms. We estimated percentages, as well as univariable and multivariable logistic regression models, to examine the relationship between depression and employment among young adults (ages 18-34 years), middle-age adults (ages 35-54 years), and older adults (ages 55-64 years).
Among all working-age US adults with arthritis, the prevalence of depressive symptoms was 13%. Those reporting depressive symptoms had a higher prevalence of fair/worse health (60%) and arthritis-attributable activity limitations (70%) compared to those not reporting depression (23% and 39%, respectively). Respondents with depressive symptoms reported significantly lower employment prevalence (30%) when compared to those not reporting depressive symptoms (66%) and lower multivariable-adjusted association with employment (prevalence ratio 0.88 [95% confidence interval (95% CI) 0.83-0.93]). Middle-age adults reporting depression were significantly less likely to be employed compared to their counterparts without depression (prevalence ratio 0.83 [95% CI 0.77-0.90]); similar but borderline statistically significant relationships were observed for both young adults (prevalence ratio 0.86 [95% CI 0.74-0.99]) and older adults (prevalence ratio 0.94 [95% CI 0.86-1.03]).
For adults with arthritis, depressive symptoms are associated with not participating in employment. Strategies to reduce arthritis-related work disability may be more effective if they simultaneously address mental health.
探讨抑郁症状、关节炎和就业之间的关系，并确定这种关系是否因不同年龄段（青年、中年和老年）的关节炎患者而有所不同。
分析了 2013 年至 2017 年美国国家健康访谈调查的数据。分析仅限于患有医生诊断的关节炎的工作年龄成年人（18-64 岁），这些人有完整的抑郁症状数据（n=11380）。协变量包括社会人口统计学信息、健康状况和卫生系统利用变量。通过自我报告的抑郁症状比较就业的流行率。我们估计了百分比，以及单变量和多变量逻辑回归模型，以研究青年（18-34 岁）、中年（35-54 岁）和老年（55-64 岁）成年人中抑郁与就业之间的关系。
在所有患有关节炎的美国工作年龄成年人中，抑郁症状的患病率为 13%。报告抑郁症状的人，其健康状况不佳（60%）和关节炎相关的活动受限（70%）的比例明显高于不报告抑郁的人（分别为 23%和 39%）。与不报告抑郁症状的人相比，有抑郁症状的受访者报告的就业比例明显较低（30%），而多变量调整后的就业关联也较低（患病比 0.88[95%置信区间（95%CI）0.83-0.93]）。报告抑郁的中年成年人与没有抑郁的同龄人相比，就业的可能性明显较低（患病比 0.83[95%CI 0.77-0.90]）；类似但具有统计学意义的关系也在青年成年人（患病比 0.86[95%CI 0.74-0.99]）和老年成年人（患病比 0.94[95%CI 0.86-1.03]）中观察到。
对于患有关节炎的成年人，抑郁症状与不参与就业有关。如果减少关节炎相关工作残疾的策略同时解决心理健康问题，可能会更有效。
