# Young adults with a history of depression and/or anxiety: the role of sociodemographic and health-related factors in not being sickness absent

## TL;DR

This study explores why some young adults with a history of depression or anxiety remain at work without taking sick leave, focusing on health-related factors.

## Contribution

The study identifies health-related factors that help maintain work ability in young adults with mental health issues.

## Key findings

- Lower use of antidepressants is linked to not taking sick leave among employees with a history of depression or anxiety.
- Fewer outpatient health care visits are associated with maintaining work ability.
- White-collar work is linked to not taking sick leave only in private sector employees.

## Abstract

The continuity of mental health problems from childhood to adulthood is well acknowledged, as is the impact on work ability. However, knowledge is scarce about individuals who maintain work ability and have no sickness absence (SA), despite mental health problems. The aim was to identify sociodemographic and health-related factors among private and public employees with a history of depression and/or anxiety, and no SA.

This prospective cohort study included 9039 Swedish twin individuals born between 1975 and 1986, with and without a history of depression and/or anxiety, and employed in the private or public sectors. Survey data from 2005 were used to classify self-rated depression, anxiety, and overall health. Data on SA, education, occupational class, outpatient health care use, and prescribed antidepressants were obtained from national registries. Participants were prospectively followed for SA from 2006 to 2020. Logistic regression analyses were applied to calculate odds ratios (ORs) with 95% CIs.

Approximately 37% of individuals with previous depression and/or anxiety were not on SA during follow-up, compared with 54% of those without such history. Lower use of antidepressants implied higher odds for no SA among both private (OR: 2.09; 95% CI, 1.64-2.66) and public (OR: 2.38; 95% CI, 1.78-3.19) employees with previous depression and/or anxiety. Having fewer visits to outpatient health care was significantly associated with no SA (ORs: 2.22-3.60). Being a white-collar worker implied higher odds for no SA only among those privately employed (OR: 1.39; 95% CI, 1.10-1.76).

Primarily, health-related factors seemed to play a role in no SA among young employees with previous depression and/or anxiety.

Key Points

What is already known on this topic:
 Mental health problems in early life increase the risk of future sickness absence. However, knowledge is scarce on what factors contribute to maintaining work ability among young adults with previous mental health problems.

Mental health problems in early life increase the risk of future sickness absence. However, knowledge is scarce on what factors contribute to maintaining work ability among young adults with previous mental health problems.

What this study adds:
 Several health-related, but not sociodemographic, factors tend to be important for maintaining work ability among both privately and publicly employed individuals with a history of depression and/or anxiety.

Several health-related, but not sociodemographic, factors tend to be important for maintaining work ability among both privately and publicly employed individuals with a history of depression and/or anxiety.

How this study might affect research, practice, or policy:
 Future research of work ability among individuals with mental health problems needs to consider health-related factors.

Future research of work ability among individuals with mental health problems needs to consider health-related factors.