Institute for Work and Health, Toronto, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Soc Psychiatry Psychiatr Epidemiol. 2024 Jun;59(6):1013-1027. doi: 10.1007/s00127-023-02547-4. Epub 2023 Sep 7.
To estimate the working life expectancies (WLE) of men and women with depression, examining depression by symptom trajectories from the late 20s to early 50s, and to estimate WLE by race/ethnicity and educational attainment.
Data from 9206 participants collected from 1979 to 2018 in the US National Longitudinal Survey of Youth 1979 cohort were used. Depression was measured using the Center for Epidemiologic Studies Depression Scale Short Form at four time points (age 28-35, age 30-37, age 40, and age 50). Labor force status was measured monthly starting at age 30 until age 58-62. Depressive symptom trajectories were estimated using growth mixture modeling and multistate modeling estimated WLE from age 30-60 for each gender and depressive symptom trajectory.
Five latent symptom trajectories were established: a persistent low symptom trajectory (n = 6838), an episodic trajectory with high symptoms occurring before age 40 (n = 995), an episodic trajectory with high symptoms occurring around age 40 (n = 526), a trajectory with high symptoms occurring around age 50 (n = 570), and a persistent high symptom trajectory (n = 277). The WLE for men at age 30 was 30.3 years for the persistent low symptom trajectory, 22.8 years for the episodic before 40 trajectory, 19.6 years for the episodic around age 40 trajectory, 18.6 years for the episodic around age 50 trajectory, and 13.2 years for the persistent high symptom trajectory. Results were similar for women. WLE disparities between depression trajectories grew when stratified by race/ethnicity and education level.
Roughly a quarter of individuals experienced episodic depressive symptoms. However, despite periods of low depressive symptoms, individuals were expected to be employed ~5-17 years less at age 30 compared to those with low symptoms. Accessible employment and mental health disability support policies and programs across the working life course may be effective in maintaining work attachment and improving WLE among those who experience depression.
通过对 20 多岁至 50 多岁期间的症状轨迹来评估男性和女性抑郁症患者的预期工作寿命（WLE），并根据种族/民族和教育程度来估计 WLE。
使用美国全国青年纵向调查 1979 年队列中的 9206 名参与者在 1979 年至 2018 年期间收集的数据。使用中心流行病学研究抑郁量表短表在四个时间点（28-35 岁、30-37 岁、40 岁和 50 岁）测量抑郁情况。从 30 岁开始，劳动力状况每月测量一次，直到 58-62 岁。使用增长混合模型估计抑郁症状轨迹，使用多状态模型估计每个性别和抑郁症状轨迹从 30 岁到 60 岁的 WLE。
建立了五个潜在的症状轨迹：持续低症状轨迹（n=6838）、40 岁前出现高症状的发作性轨迹（n=995）、40 岁左右出现高症状的发作性轨迹（n=526）、50 岁左右出现高症状的轨迹（n=570）和持续高症状轨迹（n=277）。30 岁男性持续低症状轨迹的 WLE 为 30.3 年，40 岁前发作性轨迹的 WLE 为 22.8 年，40 岁左右发作性轨迹的 WLE 为 19.6 年，50 岁左右发作性轨迹的 WLE 为 18.6 年，持续高症状轨迹的 WLE 为 13.2 年。女性的结果类似。按种族/民族和教育程度分层后，抑郁轨迹之间的 WLE 差异增大。
大约四分之一的人经历过发作性抑郁症状。然而，尽管有一段时间的抑郁症状较轻，但与那些症状较轻的人相比，这些人在 30 岁时预计就业时间会减少 5-17 年。在整个工作过程中提供可获得的就业和精神健康残疾支持政策和计划，可能有助于保持与工作的联系，并改善那些经历过抑郁症的人的 WLE。
