Unemployment and initiation of psychotropic medication: a case-crossover study of 2 348 552 Norwegian employees

Kaspersen, Silje Lill; Pape, Kristine; Ose, Solveig Osborg; Gunnell, David; Bjørngaard, Johan Håkon

doi:10.1136/oemed-2016-103578

Cited by 14 publications

(32 citation statements)

References 40 publications

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“…Other recent studies from Norway [14] and Sweden [15] have addressed the direction of the association by examining trajectories of psychotropic medication before and after the onset of unemployment. Overall, these studies suggest that in addition to health selection, at least short-term effects of unemployment on mental ill health are likely.…”

Section: Introductionmentioning

confidence: 99%

“…Overall, these studies suggest that in addition to health selection, at least short-term effects of unemployment on mental ill health are likely. However, the largest effect appeared to occur at a time of anticipation of job loss instead of after the onset of unemployment [14]. Furthermore, a mental health decline was observed among individuals experiencing downsizing more generally, and not solely among those who subsequently become unemployed [15].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, previous studies suggest that the association with mental ill health becomes stronger with longer duration of unemployment [1, 2, 11, 14] and with recurrent or cumulative exposures [16–19]. Other studies have, however, found that mental ill health after job loss and unemployment does not necessarily increase with recurrent exposures among the initially employed [20] or among older adults approaching retirement age [21].…”

Section: Introductionmentioning

confidence: 99%

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Trajectories of Antidepressant Medication before and after the Onset of Unemployment by Subsequent Employment Experience

Leinonen

Mäki²,

Martikainen

2017

PLoS ONE

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BackgroundThe unemployed more often suffer from depression than the employed. We examined whether mental health deterioration occurs already before unemployment implicating health selection, or whether it mostly occurs after becoming exposed to the experience rendering causal explanations more likely.MethodsWe used nationally representative Finnish register data to examine changes in depressive morbidity as measured by antidepressant medication in 1995–2009 over four years before and since a new onset of unemployment (N = 28 000) at the age of 30–60 compared to the employed (N = 124 136). We examined separately those who became continuously long-term unemployed, intermittently unemployed and unemployed with eventual re-employment in the second, third or fourth year since the year of onset. Annual repeated measurements were analysed using generalised estimation equations.ResultsAmong the employed antidepressant medication increased slowly but steadily over the study period and it was mainly at a lower level than among the unemployed. In the four years leading to unemployment there was excess increase in medication that was generally stronger among those with longer duration of the eventual unemployment experience. During unemployment medication decreased in all groups except among the intermittently unemployed. By the first year of re-employment antidepressant medication reached a level similar to that among the employed and afterwards followed no consistent trend.ConclusionsThe associations of unemployment and re-employment with depressive morbidity appear to be largely driven by health selection. The question of potential causal associations remains unresolved for intermittent unemployment in particular.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trajectories of Antidepressant Medication before and after the Onset of Unemployment by Subsequent Employment Experience

Leinonen

Mäki²,

Martikainen

2017

PLoS ONE

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“…This edition of the Occupational and Environmental Medicine includes an analysis of the link between unemployment benefits and purchased prescription drugs, and to what extent the two tended to co-occur over a 6-year period 1. The authors show that an incident prescription of a psychotropic drug was twofold to threefold more likely to occur close to a period of unemployment than the same individual's risk when unemployment was not an issue.…”

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confidence: 99%

Unemployment and mental health

Øverland

2016

Occup Environ Med

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“…The 2008 recession involved multiple economic processes, extending over at least 10 years, which could all negatively affect health. [2][3][4][5][6][7][8][9] In the UK, house repossessions started increasing in 2005, unemployment rose in 2008, and wages fell from 2009 to 2015 (fig 1). Secondly, there are multiple lag times between these exposures and health outcomes.…”

mentioning

confidence: 99%