Work disability trajectories before and after common mental disorder among youth in private sector

BACKGROUND: Little is known regarding work disability (sick leave and disability pension) among young employees in the private sector with common mental disorder (CMD) i.e. depression, anxiety and stress-related disorders. We aim to identify a) trajectory groups of work disability among young private sector employees in Sweden 3 years before and 6 years after a CMD diagnosis and b) investigate if sociodemographic, work- and health-related factors were associated with trajectory membership. METHODS: A longitudinal nationwide register-based study was conducted including all individuals aged 22-29 years, gainfully employed who had a CMD diagnosis in specialised healthcare or had prescribed antidepressant (N = 12,121) in 2014 (Y0), with follow-up from Y-3 - Y + 6. Group-based trajectory analysis was used to identify groups of individuals who followed similar trajectories of months of work disability. Multinomial logistic regression was used to determine associations between sociodemographic, work and health-related factors and trajectory membership. RESULTS: We identified three trajectories. Most individuals were in the ‘constant low’ trajectory with almost no work disability (57%) from Y-3 - Y + 6, followed by an ‘increasing low’ trajectory (36%) of around 1 month work disability each year and a ‘fluctuant high’ trajectory (7%) reaching 7 months of work disability in Y + 3 and declining to 5 months in Y + 6. Being women, low education and history of specialised healthcare use for musculoskeletal disorder was associated with belonging in the ‘increasing low’ and ‘fluctuant high’ trajectories. Work-related factors i.e. occupational class (non-manual/manual work) and branch (e.g. healthcare) had weak to no association with any trajectory membership. CONCLUSIONS: Among young individuals working in the private sector, women, those with low education and those with musculoskeletal disorder require special attention regarding their return-to-work process following a CMD diagnosis. KEY MESSAGES: • Most (57%) young private sector employees had almost no work disability (WD) during 6 years after a common mental disorder (CMD) while 7% had almost 7 months of WD still 3-4 years after CMD. • Women, those with low education and with musculoskeletal disorder require special attention regarding their return-to-work process following a CMD diagnosis among young private sector employees.