Majuri Tuomas, Huikari Sanna, Jääskeläinen Erika, Ala-Mursula Leena, Rissanen Ina, Korhonen Marko
Research Unit of Population Health, University of Oulu, Finland.
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland.
Int J Soc Psychiatry. 2025 Jun;71(4):682-693. doi: 10.1177/00207640241299384. Epub 2024 Nov 27.
Both the symptoms and diagnoses of mental health disorders affect individuals' occupational status and income. However, studies that compare the impact of differences between symptoms and diagnoses on occupational outcomes are lacking.
This study aimed to compare labour market attachment and income until midlife between individuals with different histories of mental disorder symptoms and diagnoses.
Utilizing the Northern Finland Birth Cohort 1966 with linkages to national registers and self-reported mental disorder symptoms at the age of 31, we compared labour market attachment and income until midlife among individuals with neither mental disorder symptoms nor a diagnosis (reference group), symptomatic undiagnosed mental disorder, asymptomatic diagnosed mental disorder, and with symptomatic diagnosed mental disorder by using cross-tabulations and regression analyses. We stratified our analysis by sex.
Compared to the reference group, males but not females with symptomatic undiagnosed mental disorder had an increased risk for poor labour market attachment, with Odds Ratios (95% Confidence intervals) 2.26 [1.41, 3.63] and 0.87 [0.63, 1.19], respectively. The analogous risk was heightened for both males and females with asymptomatic diagnosed mental disorders or symptomatic diagnosed mental disorders. Regarding income, having mental disorder symptoms, a diagnosis, or both was associated with lower earnings irrespective of sex.
Mental disorder symptoms and diagnoses are differently associated with labour market attachment and income. Our findings suggest that interventions should be offered not only based on diagnoses but also based on symptoms as they may serve as predictors of future challenges related to work careers.
心理健康障碍的症状和诊断都会影响个人的职业状况和收入。然而,缺乏比较症状和诊断差异对职业结果影响的研究。
本研究旨在比较有不同精神障碍症状和诊断史的个体在中年之前的劳动力市场依恋度和收入。
利用1966年芬兰北部出生队列与国家登记册的关联以及31岁时自我报告的精神障碍症状,我们通过交叉表和回归分析比较了既无精神障碍症状也无诊断的个体(参照组)、有症状但未确诊的精神障碍个体、无症状但已确诊的精神障碍个体以及有症状且已确诊的精神障碍个体在中年之前的劳动力市场依恋度和收入。我们按性别对分析进行分层。
与参照组相比,有症状但未确诊精神障碍的男性而非女性劳动力市场依恋度差的风险增加,优势比(95%置信区间)分别为2.26 [1.41, 3.63] 和0.87 [0.63, 1.19]。无症状但已确诊精神障碍或有症状且已确诊精神障碍的男性和女性的类似风险都有所增加。关于收入,无论性别,有精神障碍症状、诊断或两者皆有都与较低收入相关。
精神障碍症状和诊断与劳动力市场依恋度和收入的关联不同。我们的研究结果表明,不仅应基于诊断提供干预措施,还应基于症状提供干预措施,因为症状可能是未来与职业相关挑战的预测指标。