# The role of common mental disorders on sustainable working life—a cohort study among discordant Swedish twin pairs

## TL;DR

This study examines how common mental disorders affect the ability to maintain continuous work among Swedish twins, finding that most can sustain work but some with mental disorders face challenges.

## Contribution

The study identifies distinct working life patterns among twins with and without mental disorders using longitudinal data and trajectory modeling.

## Key findings

- Most individuals with and without CMDs maintained sustainable working life, but a minority did not.
- Higher education reduced the likelihood of non-sustainable working life, while being single increased it.
- A subset of those with CMDs showed a decreasing pattern of sustainable working life over time.

## Abstract

To investigate patterns of sustainable working life, defined as a few or no interruptions from paid work due to sickness absence, unemployment or disability pension among Swedish twins with and without common mental disorders (CMDs). We also sought to examine the role of baseline sociodemographic factors for the identified patterns.

Prospective cohort study.

Population-based sample of twins born in Sweden.

The sample of 5529 CMDs, discordant twin pairs between ages 18 and 59 years at baseline in 1998 (50% women) were followed annually for working life statuses using data obtained from national registers until 2020.

Sustainable working life.

Group-based trajectory modelling was applied to identify distinct trajectory groups. Multinomial logistic regression models estimating ORs were performed.

For those with CMDs, a three-trajectory solution was the best-fitting model, while for those without CMDs, a two-trajectory solution had best fit; in both groups, sustainable working life constituted the largest trajectory group (71% and 83%, respectively). No sustainable working life yielded 14.5% and 17% in those with CMDs and those without CMDs, respectively, whereas, among those with CMDs, another 14.5% had a trajectory with decreasing sustainable working life. Higher education was associated with a lower likelihood (OR 0.12–0.47) and being single (with or without children, OR 2.23–2.51) with a higher likelihood of belonging to those trajectories characterised by no sustainable working life.

A small cluster among those with CMDs tended to follow a decreasing sustainable working life pattern, while a minority with or without CMDs had no sustainable working life. Although a sustainable working life seems common, those with CMDs should be identified early for preventive actions and support to remain in paid work.