Helgesson Magnus, Kjeldgård Linnea, Björkenstam Emma, Rahman Syed, Gustafsson Klas, Taipale Heidi, Tanskanen Antti, Ekselius Lisa, Mittendorfer-Rutz Ellenor
Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden.
Department of Public Health and Caring Sciences, Health Equity and Working Life, Uppsala University, SE-752 37, Uppsala, Sweden.
SSM Popul Health. 2023 Jun 12;23:101444. doi: 10.1016/j.ssmph.2023.101444. eCollection 2023 Sep.
The aims were to study the sustainability of labour-market participation five years after an incident diagnosis of attention-deficit/hyperactivity disorder (ADHD) among young adults with gainful employment, and to examine the impact of sociodemographic-, work- and health-related factors on these findings.
Swedish registers identified 2517 individuals, 19-29 years old, with an incident diagnosis of ADHD and gainful employment during 2006-2011. Labour-market participation was measured by the core-peripheral model, a model that measures the connection to the labour market from a weak connection (peripheral) to a strong connection (core). Sequence analysis analysed clusters of labour-market participation, from one year before and up to five years after diagnosis. Odds ratios (OR) with 95% confidence intervals (CI) between sociodemographic factors, comorbid disorders, and the identified clusters were analysed by multinomial logistic regression.
Five clusters of labour-market participation were identified: 60% of individuals belonged to a cluster that maintained labour-market participation throughout the study period (core, close to core); 20% belonged to a cluster with a transition to a weak connection to the labour market (close to peripheral, peripheral); and 20% belonged to a cluster with "middle" labour-market participation, characterised by having long periods of sick leave and unemployment. Individuals with elementary school as highest attained education (OR:4.03;CI:2.35-6.93), comorbid mental disorders (OR:2.77;CI:2.10-3.66), or living in villages/small cities (OR:1.77;CI:1.25-2.51) were most likely to belong to a cluster transitioning towards a "peripheral" labour-market participation. Men were less likely to have peripheral labour-market participation than women (OR:0.55;CI:0.40-0.75).
Over half of working individuals with ADHD maintain a strong attachment to the labour market several years after their first diagnosis of ADHD. Therefore, it is important to target those who have problems maintaining a position in the labour market, including women, those with low educational levels, and those living outside large cities.
目的是研究初次诊断为注意力缺陷多动障碍（ADHD）的有酬就业青年成年人在五年后的劳动力市场参与可持续性，并研究社会人口学、工作和健康相关因素对这些结果的影响。
瑞典登记系统识别出2517名年龄在19至29岁之间、在2006年至2011年期间初次诊断为ADHD且有酬就业的个体。劳动力市场参与情况通过核心-外围模型进行衡量，该模型从弱连接（外围）到强连接（核心）来衡量与劳动力市场的联系。序列分析对诊断前一年至诊断后五年的劳动力市场参与集群进行了分析。通过多项逻辑回归分析社会人口学因素、共病障碍与所识别集群之间的比值比（OR）及95%置信区间（CI）。
识别出了五类劳动力市场参与集群：60%的个体属于在整个研究期间保持劳动力市场参与的集群（核心、接近核心）；20%属于向与劳动力市场的弱连接转变的集群（接近外围、外围）；20%属于具有“中等”劳动力市场参与的集群，其特征是有长时间的病假和失业情况。最高学历为小学的个体（OR：4.03；CI：2.35 - 6.93）、患有共病精神障碍的个体（OR：2.77；CI：2.10 - 3.66）或居住在乡村/小城市的个体（OR：1.77；CI：1.25 - 2.51）最有可能属于向“外围”劳动力市场参与转变的集群。男性比女性更不容易有外围劳动力市场参与（OR：0.55；CI：0.40 - 0.75）。
超过半数患有ADHD的在职个体在首次诊断ADHD后的数年内仍与劳动力市场保持紧密联系。因此，针对那些在劳动力市场中难以维持职位的人群很重要，包括女性、低学历者以及居住在大城市以外的人群。
