Occupational Factors and Labor Market Outcomes Among Individuals with Sickness Absence due to Common Mental Disorders: A Population-Wide Cohort Study

Purpose To investigate how job demands, control, strain, and occupational sector and branch affect labor market outcomes following sickness absence (SA) due to common mental disorders (CMDs). Methods This nationwide register-based cohort study included all residents in Sweden aged 25–55 who began a new > 30-day SA spell due to a CMD (ICD-10: F32-33, F40-43) in 2011–2013 (n = 79,673). Occupational sector and branch were identified through registers, and job demands, control, and strain were assessed using the Swedish Job Exposure Matrix. We used multinomial logistic regression to estimate associations between occupational factors and different unemployment and SA/disability pension (DP) durations during a three-year follow-up. Results Public sector workers were less likely to have > 180 unemployment days (OR = 0.3, 95% CI: 0.31–0.35). Working in education and public administration and in health and social services was associated with a lower likelihood of > 180 unemployment days, but a higher likelihood of > 365 SA/DP days. Low-control, passive (low control/low demands), and high-strain (low control/high demand) jobs were associated with an increased likelihood of both > 180 unemployment days and > 365 SA/DP days. For > 180 unemployment days, the ORs were 1.7 (95% CI: 1.62–1.82) for low-control, 1.8 (95% CI: 1.70–1.98) for passive, and 1.4 (95% CI: 1.23–1.54) for high-strain jobs. For > 365 SA/DP days, the ORs were 1.3 (95% CI: 1.22–1.34), 1.3 (95% CI: 1.22–1.41), and 1.3 (95% CI: 1.15–1.39), respectively. Conclusion Particularly among individuals with SA due to CMDs, job demands, control, and strain are associated with future labor market exclusion and may be important targets for intervention.