Department of Health Sciences, Community & Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Statistics, Uppsala University, Uppsala, Sweden.
Eur J Public Health. 2022 Feb 1;32(1):8-13. doi: 10.1093/eurpub/ckab185.
Little is known about factors that may explain the association between depressive symptoms and poor labour market participation (LMP). The aim of this study is to examine the mediation and interaction effects of social support on the association between depressive symptoms and LMP.
Data were used from 985 participants (91% of the initial cohort) of the Northern Swedish Cohort, a longitudinal study of Swedish participants followed from adolescence throughout adulthood. Depressive symptoms were measured at age 16, social support at age 21 and LMP from age 30 to 43. Poor LMP was defined as being unemployed for a total of 6 months or more between the ages of 30 and 43. A four-way decomposition approach was applied to identify direct, mediation and interaction effects, together and separately.
Both depressive symptoms during adolescence and social support at young adulthood were associated with poor LMP [odds ratio (OR) = 1.70, 95% confidence interval (CI) 1.17-2.47 and OR = 2.56, 95% CI 1.78-3.68 respectively]. The association between depressive symptoms and poor LMP was partially mediated by a lack of social support. No interaction effect of a lack of social support was found.
The results suggest that depressive symptoms influence not only later LMP but also the intermediary level of social support, and in turn influencing later LMP. Recommendations for public health are to detect and treat depressive symptoms at an early stage and to focus on the development of social skills, facilitating the increased availability of social support, thereby improving future LMP.
对于可能解释抑郁症状与较差劳动力市场参与（LMP）之间关联的因素知之甚少。本研究旨在检验社会支持对抑郁症状与 LMP 之间关联的中介和交互作用。
使用了来自瑞典北部队列的 985 名参与者（初始队列的 91%）的数据，这是一项对瑞典参与者从青春期到成年期进行的纵向研究。抑郁症状在 16 岁时测量，社会支持在 21 岁时测量，LMP 在 30 岁至 43 岁之间测量。较差的 LMP 定义为在 30 岁至 43 岁之间总共失业 6 个月或更长时间。采用四向分解方法来识别直接、中介和交互作用，分别和共同作用。
青少年时期的抑郁症状和成年早期的社会支持均与较差的 LMP 相关（比值比[OR] = 1.70，95%置信区间[CI] 1.17-2.47 和 OR = 2.56，95% CI 1.78-3.68）。抑郁症状与较差 LMP 之间的关联部分通过缺乏社会支持来介导。没有发现缺乏社会支持的交互作用效应。
结果表明，抑郁症状不仅影响以后的 LMP，还影响社会支持的中介水平，从而影响以后的 LMP。公共卫生的建议是在早期发现和治疗抑郁症状，并注重社会技能的发展，促进社会支持的增加，从而提高未来的 LMP。
