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Association of common mental disorders and related multimorbidity with subsequent labor market marginalization among refugee and Swedish-born young adults

BACKGROUND: Common mental disorders (CMDs), multimorbidity, and refugee status are associated with poor labor market outcome. Little is known about how these factors interact in young adults. OBJECTIVE: We aimed to i) investigate whether the association of CMDs and multimorbidity with labor market m...

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Autores principales: Chen, Jiaying, Mittendorfer-Rutz, Ellenor, Berg, Lisa, Nørredam, Marie, Sijbrandij, Marit, Klimek, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060531/
https://www.ncbi.nlm.nih.gov/pubmed/37006549
http://dx.doi.org/10.3389/fpubh.2023.1054261
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author Chen, Jiaying
Mittendorfer-Rutz, Ellenor
Berg, Lisa
Nørredam, Marie
Sijbrandij, Marit
Klimek, Peter
author_facet Chen, Jiaying
Mittendorfer-Rutz, Ellenor
Berg, Lisa
Nørredam, Marie
Sijbrandij, Marit
Klimek, Peter
author_sort Chen, Jiaying
collection PubMed
description BACKGROUND: Common mental disorders (CMDs), multimorbidity, and refugee status are associated with poor labor market outcome. Little is known about how these factors interact in young adults. OBJECTIVE: We aimed to i) investigate whether the association of CMDs and multimorbidity with labor market marginalization (LMM) differs between refugee and Swedish-born young adults and ii) identify diagnostic groups with particularly high risk for LMM. METHODS: This longitudinal registry-based study included individuals aged 20–25 years followed from 2012 to 2016 in Sweden (41,516 refugees and 207,729 age and sex-matched Swedish-born individuals). LMM was defined as granted disability pension (DP) or > 180 days of unemployment (UE). A disease co-occurrence network was constructed for all diagnostic groups from 2009 to 2011 to derive a personalized multimorbidity score for LMM. Multivariate logistic regression was used to estimate odds ratios of LMM in refugee and Swedish-born youth as a function of their multimorbidity score. The relative risk (RR, 95% CI) of LMM for refugees with CMDs compared to Swedish-born with CMDs was computed in each diagnostic group. RESULTS: In total, 5.5% of refugees and 7.2% of Swedish-born with CMDs were granted DP; 22.2 and 9.4%, respectively received UE benefit during follow-up. While both CMDs and multimorbidity independently elevated the risk of DP considerably in Swedish-born, CMDs but not multimorbidity elevated the risk of UE. Regarding UE in refugees, multimorbidity with the presence of CMDs showed stronger estimates. Multimorbidity interacted with refugee status toward UE (p < 0.0001) and with CMDs toward DP (p = 0.0049). Two diagnostic groups that demonstrated particularly high RR of UE were schizophrenia, schizotypal and delusional disorders (RR [95% CI]: 3.46 [1.77, 6.75]), and behavioral syndromes (RR [95% CI]: 3.41 [1.90, 6.10]). CONCLUSION: To combat LMM, public health measures and intervention strategies need to be tailored to young adults based on their CMDs, multimorbidity, and refugee status.
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spelling pubmed-100605312023-03-31 Association of common mental disorders and related multimorbidity with subsequent labor market marginalization among refugee and Swedish-born young adults Chen, Jiaying Mittendorfer-Rutz, Ellenor Berg, Lisa Nørredam, Marie Sijbrandij, Marit Klimek, Peter Front Public Health Public Health BACKGROUND: Common mental disorders (CMDs), multimorbidity, and refugee status are associated with poor labor market outcome. Little is known about how these factors interact in young adults. OBJECTIVE: We aimed to i) investigate whether the association of CMDs and multimorbidity with labor market marginalization (LMM) differs between refugee and Swedish-born young adults and ii) identify diagnostic groups with particularly high risk for LMM. METHODS: This longitudinal registry-based study included individuals aged 20–25 years followed from 2012 to 2016 in Sweden (41,516 refugees and 207,729 age and sex-matched Swedish-born individuals). LMM was defined as granted disability pension (DP) or > 180 days of unemployment (UE). A disease co-occurrence network was constructed for all diagnostic groups from 2009 to 2011 to derive a personalized multimorbidity score for LMM. Multivariate logistic regression was used to estimate odds ratios of LMM in refugee and Swedish-born youth as a function of their multimorbidity score. The relative risk (RR, 95% CI) of LMM for refugees with CMDs compared to Swedish-born with CMDs was computed in each diagnostic group. RESULTS: In total, 5.5% of refugees and 7.2% of Swedish-born with CMDs were granted DP; 22.2 and 9.4%, respectively received UE benefit during follow-up. While both CMDs and multimorbidity independently elevated the risk of DP considerably in Swedish-born, CMDs but not multimorbidity elevated the risk of UE. Regarding UE in refugees, multimorbidity with the presence of CMDs showed stronger estimates. Multimorbidity interacted with refugee status toward UE (p < 0.0001) and with CMDs toward DP (p = 0.0049). Two diagnostic groups that demonstrated particularly high RR of UE were schizophrenia, schizotypal and delusional disorders (RR [95% CI]: 3.46 [1.77, 6.75]), and behavioral syndromes (RR [95% CI]: 3.41 [1.90, 6.10]). CONCLUSION: To combat LMM, public health measures and intervention strategies need to be tailored to young adults based on their CMDs, multimorbidity, and refugee status. Frontiers Media S.A. 2023-03-16 /pmc/articles/PMC10060531/ /pubmed/37006549 http://dx.doi.org/10.3389/fpubh.2023.1054261 Text en Copyright © 2023 Chen, Mittendorfer-Rutz, Berg, Nørredam, Sijbrandij and Klimek. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Chen, Jiaying
Mittendorfer-Rutz, Ellenor
Berg, Lisa
Nørredam, Marie
Sijbrandij, Marit
Klimek, Peter
Association of common mental disorders and related multimorbidity with subsequent labor market marginalization among refugee and Swedish-born young adults
title Association of common mental disorders and related multimorbidity with subsequent labor market marginalization among refugee and Swedish-born young adults
title_full Association of common mental disorders and related multimorbidity with subsequent labor market marginalization among refugee and Swedish-born young adults
title_fullStr Association of common mental disorders and related multimorbidity with subsequent labor market marginalization among refugee and Swedish-born young adults
title_full_unstemmed Association of common mental disorders and related multimorbidity with subsequent labor market marginalization among refugee and Swedish-born young adults
title_short Association of common mental disorders and related multimorbidity with subsequent labor market marginalization among refugee and Swedish-born young adults
title_sort association of common mental disorders and related multimorbidity with subsequent labor market marginalization among refugee and swedish-born young adults
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060531/
https://www.ncbi.nlm.nih.gov/pubmed/37006549
http://dx.doi.org/10.3389/fpubh.2023.1054261
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