Background The aims were to elucidate if trajectories of labour market marginalization (LMM), measured as sickness absence (SA)/disability pension (DP) or unemployment, differed between young immigrants and natives before and after an incident diagnosis of a common mental disorder (CMD), and to investigate if educational level, psychiatric comorbidity and duration of residence in Sweden (in immigrants) had different associations with subsequent LMM in natives compared with immigrants. Methods A total of 28 971 young adults (19–30 years), with an incident CMD (inpatient or specialized outpatient healthcare due to CMDs or dispensed prescribed antidepressants during 2007) were included. Group-based trajectory models were utilized to identify trajectories of annual months of LMM 3 years before and 6 years after the diagnosis. The associations of risk factors with different trajectories were investigated by multinomial logistic regression, χ2-test and Nagelkerke R2 to measure the associations’ strength. Immigrants were categorized into Western and non-Western immigrants. Results Young natives and immigrants showed similar trajectories of SA/DP. A higher proportion of non-Western immigrants (20.5%) followed trajectories of high levels of unemployment (>2 annual months) compared with Western immigrants (15%) and natives (16.5%). Educational level and duration of residence in Sweden (in immigrants) discriminated trajectories of both SA/DP and unemployment, whereas psychiatric comorbidity only discriminated trajectories of SA/DP. Conclusions Differences in trajectories of unemployment between young natives and immigrants with an incident CMD were found. Educational level and psychiatric comorbidity provided information on differences between natives and immigrants and duration of residence gave information for subgroups of immigrants.

Background: Chronic widespread pain (CWP) and common mental disorders (CMDs) are common public health problems, but little is known about the role of CWP and CMDs on future adverse outcomes among work disabled individuals. The aims of the study were to investigate the associations between CWP and CMDs with subsequent disability pension (DP), long-term unemployment (> 90 days) and all-cause mortality in individuals with sickness absence (SA) and whether the associations were explained by familial factors. Methods: In this prospective cohort study, 7884 Swedish twins born between 1933 and 1985 were included and baseline data were gathered from a questionnaire in 1998 to 2006. Register data were used for obtaining information regarding demographics, SA, DP, unemployment and mortality. Cox proportional hazards regressions were used to calculate Hazard Ratios (HR) with 95% Confidence Intervals (CI) for the associations between CWP and/or CMDs with DP, unemployment and mortality, while conditional Cox models for twin pairs provided control for familial confounding. Results: Having either CWP or CMDs among those with a history of SA was associated with a higher risk of DP and all-cause mortality than individuals without CWP and CMDs after controlling for socio-demographic and health factors. Moreover, sick-listed individuals with both CWP and CMDs had a higher risk of DP while those who only had CMDs had a higher risk of long-term unemployment compared to those without CWP and CMDs. The association between CMDs with DP and long-term unemployment was no longer significant when controlling for familial factors. Conclusions: CMDs was a risk factor for DP, unemployment and mortality among individuals with SA, while CWP seems to be important in relation to future DP and mortality. Familial factors played a role in the associations between CMDs and DP and CMDs and unemployment.

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Purpose Previous studies have reported an elevated risk of sickness absence (SA) and disability pension (DP) due to adverse psychosocial working conditions, yet the influence of age and familial factors on the associations have not been examined. We aimed to investigate associations between psychosocial working conditions and labour market marginalisation (LMM) in terms of unemployment, SA and DP adjusting for familial confounding and possible differences in these associations with different age groups and different unemployment and sick leave days. Methods All twins living in Sweden in 2001, aged 16–64 years and not on old-age pension or DP were included (n = 56,867). The twins were followed from 2002 to 2016 regarding unemployment, SA and DP. Cox proportional hazards regression models were performed for the whole sample, and for discordant twin pairs, in five age groups. Results Each one-unit increase in job demands and job control was associated with a lower risk of unemployment, SA and DP in all age groups. Moreover, each one-unit increase in social support was associated with an increased risk of 1–30 days unemployment in individuals older than 45 years and SA and DP. Social support decreased the risk of unemployment longer than 365 days in age groups 16–25 and 36–45 years. In the discordant twin pair analyses, the estimates attenuated towards statistical non-significance. Conclusion Even though familial factors seem to influence the associations between psychosocial working conditions and LMM, improving psychosocial working conditions by for example promoting high job control and social support at workplace may reduce the risk of future short- and long-term LMM in all age groups.