Effects of depression on employment and social outcomes: a Mendelian randomisation study

Desmond Campbell; Michael James Green; Neil Davies; Evangelia Demou; Laura D Howe; Sean Harrison; Daniel J Smith; David M Howard; Andrew M McIntosh; Marcus Munafò; Srinivasa Vittal Katikireddi

doi:10.1136/jech-2021-218074

Effects of depression on employment and social outcomes: a Mendelian randomisation study

Desmond Campbell^*, Michael James Green, Neil Davies, Evangelia Demou, Laura D Howe, Sean Harrison, Daniel J Smith, David M Howard, Andrew M McIntosh, Marcus Munafò, Srinivasa Vittal Katikireddi

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Abstract

BACKGROUND: Depression is associated with socioeconomic disadvantage. However, whether and how depression exerts a causal effect on employment remains unclear. We used Mendelian randomisation (MR) to investigate whether depression affects employment and related outcomes in the UK Biobank dataset.

METHODS: We selected 227 242 working-age participants (40-64 in men, 40-59 years for women) of white British ethnicity/ancestry with suitable genetic data in the UK Biobank study. We used 30 independent genetic variants associated with depression as instruments. We conducted observational and two-sample MR analyses. Outcomes were employment status (employed vs not, and employed vs sickness/disability, unemployment, retirement or caring for home/family); weekly hours worked (among employed); Townsend Deprivation Index; highest educational attainment; and household income.

RESULTS: People who had experienced depression had higher odds of non-employment, sickness/disability, unemployment, caring for home/family and early retirement. Depression was associated with reduced weekly hours worked, lower household income and lower educational attainment, and increased deprivation. MR analyses suggested depression liability caused increased non-employment (OR 1.16, 95% CI 1.06 to 1.26) and sickness/disability (OR 1.56, 95% CI 1.34 to 1.82), but was not causal for caring for home/family, early retirement or unemployment. There was little evidence from MR that depression affected weekly hours worked, educational attainment, household income or deprivation.

CONCLUSIONS: Depression liability appears to cause increased non-employment, particularly by increasing disability. There was little evidence of depression affecting early retirement, hours worked or household income, but power was low. Effective treatment of depression might have important economic benefits to individuals and society.

Original language	English
Article number	218074
Pages (from-to)	563-571
Number of pages	9
Journal	Journal of Epidemiology and Community Health
Volume	76
Issue number	6
Early online date	22 Mar 2022
DOIs	https://doi.org/10.1136/jech-2021-218074
Publication status	E-pub ahead of print - 22 Mar 2022

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

Funding Information:
Funding This study was conducted using data from the UK Biobank resource (application number 17333). This work is part of a project entitled ’Social and Eonomic Consequences of Health: Causal Inference Methods and Longitudinal, Intergenerational Data’, which is part of the Health Foundation’s Social and Economic Value of Health Programme (grant ref. 807293). The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. This work was further supported by the Medical Research Council (DC, MG, ED and SVK, grant ref. MC_UU_00022/2) and the Scottish Government Chief Scientist Office (DC, MG, ED and SVK, grant ref. SPHSU17), an NHS Research Scotland (NRS) Senior Clinical Fellowship (SVK, grant ref. SCAF/15/02), an Economics and Social Research Council (ESRC) Future Research Leaders grant (NMD, grant ref. ES/N000757/1), a Norwegian Research Council (NMD, grant ref. 295989), a Career Development Award from the UK Medical Research Council (LDH, grant ref. MR/M020894/1), a MRC Strategic Award (ED, grant ref. MRC_PC_13027), a Sir Henry Wellcome Postdoctoral Fellowship (DMH, grant ref. 213674/Z/18/Z), a Brain & Behavior Research Foundation 2018 NARSAD Young Investigator Grant (DMH, grant ref. 27404), the Medical Research Centre Integrative Epidemiology Unit at the University of Bristol (MM, grant ref. MC_UU_0011/1, MC_UU_0011/7), Medical Research Centre grant (AMM, grant ref. MC_PC_17209) and Wellcome Trust grants (AMM, grant ref.s 104036/Z/14/Z, 220857/Z/20/Z).

Funding Information:
Competing interests SVK reports grants from the Medical Research Council, the Health Foundation and the Scottish Government Chief Scientist Office during the conduct of this study.

Publisher Copyright:
© 2022 Authors.

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SDG 8 Decent Work and Economic Growth

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Campbell, D., Green, M. J., Davies, N., Demou, E., Howe, L. D., Harrison, S., Smith, D. J., Howard, D. M., McIntosh, A. M., Munafò, M., & Katikireddi, S. V. (2022). Effects of depression on employment and social outcomes: a Mendelian randomisation study. Journal of Epidemiology and Community Health, 76(6), 563-571. Article 218074. Advance online publication. https://doi.org/10.1136/jech-2021-218074

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title = "Effects of depression on employment and social outcomes: a Mendelian randomisation study",

abstract = "BACKGROUND: Depression is associated with socioeconomic disadvantage. However, whether and how depression exerts a causal effect on employment remains unclear. We used Mendelian randomisation (MR) to investigate whether depression affects employment and related outcomes in the UK Biobank dataset.METHODS: We selected 227 242 working-age participants (40-64 in men, 40-59 years for women) of white British ethnicity/ancestry with suitable genetic data in the UK Biobank study. We used 30 independent genetic variants associated with depression as instruments. We conducted observational and two-sample MR analyses. Outcomes were employment status (employed vs not, and employed vs sickness/disability, unemployment, retirement or caring for home/family); weekly hours worked (among employed); Townsend Deprivation Index; highest educational attainment; and household income.RESULTS: People who had experienced depression had higher odds of non-employment, sickness/disability, unemployment, caring for home/family and early retirement. Depression was associated with reduced weekly hours worked, lower household income and lower educational attainment, and increased deprivation. MR analyses suggested depression liability caused increased non-employment (OR 1.16, 95\% CI 1.06 to 1.26) and sickness/disability (OR 1.56, 95\% CI 1.34 to 1.82), but was not causal for caring for home/family, early retirement or unemployment. There was little evidence from MR that depression affected weekly hours worked, educational attainment, household income or deprivation.CONCLUSIONS: Depression liability appears to cause increased non-employment, particularly by increasing disability. There was little evidence of depression affecting early retirement, hours worked or household income, but power was low. Effective treatment of depression might have important economic benefits to individuals and society.",

author = "Desmond Campbell and Green, \{Michael James\} and Neil Davies and Evangelia Demou and Howe, \{Laura D\} and Sean Harrison and Smith, \{Daniel J\} and Howard, \{David M\} and McIntosh, \{Andrew M\} and Marcus Munaf{\`o} and Katikireddi, \{Srinivasa Vittal\}",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. Funding Information: Funding This study was conducted using data from the UK Biobank resource (application number 17333). This work is part of a project entitled {\textquoteright}Social and Eonomic Consequences of Health: Causal Inference Methods and Longitudinal, Intergenerational Data{\textquoteright}, which is part of the Health Foundation{\textquoteright}s Social and Economic Value of Health Programme (grant ref. 807293). The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. This work was further supported by the Medical Research Council (DC, MG, ED and SVK, grant ref. MC\_UU\_00022/2) and the Scottish Government Chief Scientist Office (DC, MG, ED and SVK, grant ref. SPHSU17), an NHS Research Scotland (NRS) Senior Clinical Fellowship (SVK, grant ref. SCAF/15/02), an Economics and Social Research Council (ESRC) Future Research Leaders grant (NMD, grant ref. ES/N000757/1), a Norwegian Research Council (NMD, grant ref. 295989), a Career Development Award from the UK Medical Research Council (LDH, grant ref. MR/M020894/1), a MRC Strategic Award (ED, grant ref. MRC\_PC\_13027), a Sir Henry Wellcome Postdoctoral Fellowship (DMH, grant ref. 213674/Z/18/Z), a Brain \& Behavior Research Foundation 2018 NARSAD Young Investigator Grant (DMH, grant ref. 27404), the Medical Research Centre Integrative Epidemiology Unit at the University of Bristol (MM, grant ref. MC\_UU\_0011/1, MC\_UU\_0011/7), Medical Research Centre grant (AMM, grant ref. MC\_PC\_17209) and Wellcome Trust grants (AMM, grant ref.s 104036/Z/14/Z, 220857/Z/20/Z). Funding Information: Competing interests SVK reports grants from the Medical Research Council, the Health Foundation and the Scottish Government Chief Scientist Office during the conduct of this study. Publisher Copyright: {\textcopyright} 2022 Authors.",

year = "2022",

month = mar,

day = "22",

doi = "10.1136/jech-2021-218074",

language = "English",

volume = "76",

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TY - JOUR

T1 - Effects of depression on employment and social outcomes

T2 - a Mendelian randomisation study

AU - Campbell, Desmond

AU - Green, Michael James

AU - Davies, Neil

AU - Demou, Evangelia

AU - Howe, Laura D

AU - Harrison, Sean

AU - Smith, Daniel J

AU - Howard, David M

AU - McIntosh, Andrew M

AU - Munafò, Marcus

AU - Katikireddi, Srinivasa Vittal

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. Funding Information: Funding This study was conducted using data from the UK Biobank resource (application number 17333). This work is part of a project entitled ’Social and Eonomic Consequences of Health: Causal Inference Methods and Longitudinal, Intergenerational Data’, which is part of the Health Foundation’s Social and Economic Value of Health Programme (grant ref. 807293). The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. This work was further supported by the Medical Research Council (DC, MG, ED and SVK, grant ref. MC_UU_00022/2) and the Scottish Government Chief Scientist Office (DC, MG, ED and SVK, grant ref. SPHSU17), an NHS Research Scotland (NRS) Senior Clinical Fellowship (SVK, grant ref. SCAF/15/02), an Economics and Social Research Council (ESRC) Future Research Leaders grant (NMD, grant ref. ES/N000757/1), a Norwegian Research Council (NMD, grant ref. 295989), a Career Development Award from the UK Medical Research Council (LDH, grant ref. MR/M020894/1), a MRC Strategic Award (ED, grant ref. MRC_PC_13027), a Sir Henry Wellcome Postdoctoral Fellowship (DMH, grant ref. 213674/Z/18/Z), a Brain & Behavior Research Foundation 2018 NARSAD Young Investigator Grant (DMH, grant ref. 27404), the Medical Research Centre Integrative Epidemiology Unit at the University of Bristol (MM, grant ref. MC_UU_0011/1, MC_UU_0011/7), Medical Research Centre grant (AMM, grant ref. MC_PC_17209) and Wellcome Trust grants (AMM, grant ref.s 104036/Z/14/Z, 220857/Z/20/Z). Funding Information: Competing interests SVK reports grants from the Medical Research Council, the Health Foundation and the Scottish Government Chief Scientist Office during the conduct of this study. Publisher Copyright: © 2022 Authors.

PY - 2022/3/22

Y1 - 2022/3/22

N2 - BACKGROUND: Depression is associated with socioeconomic disadvantage. However, whether and how depression exerts a causal effect on employment remains unclear. We used Mendelian randomisation (MR) to investigate whether depression affects employment and related outcomes in the UK Biobank dataset.METHODS: We selected 227 242 working-age participants (40-64 in men, 40-59 years for women) of white British ethnicity/ancestry with suitable genetic data in the UK Biobank study. We used 30 independent genetic variants associated with depression as instruments. We conducted observational and two-sample MR analyses. Outcomes were employment status (employed vs not, and employed vs sickness/disability, unemployment, retirement or caring for home/family); weekly hours worked (among employed); Townsend Deprivation Index; highest educational attainment; and household income.RESULTS: People who had experienced depression had higher odds of non-employment, sickness/disability, unemployment, caring for home/family and early retirement. Depression was associated with reduced weekly hours worked, lower household income and lower educational attainment, and increased deprivation. MR analyses suggested depression liability caused increased non-employment (OR 1.16, 95% CI 1.06 to 1.26) and sickness/disability (OR 1.56, 95% CI 1.34 to 1.82), but was not causal for caring for home/family, early retirement or unemployment. There was little evidence from MR that depression affected weekly hours worked, educational attainment, household income or deprivation.CONCLUSIONS: Depression liability appears to cause increased non-employment, particularly by increasing disability. There was little evidence of depression affecting early retirement, hours worked or household income, but power was low. Effective treatment of depression might have important economic benefits to individuals and society.

AB - BACKGROUND: Depression is associated with socioeconomic disadvantage. However, whether and how depression exerts a causal effect on employment remains unclear. We used Mendelian randomisation (MR) to investigate whether depression affects employment and related outcomes in the UK Biobank dataset.METHODS: We selected 227 242 working-age participants (40-64 in men, 40-59 years for women) of white British ethnicity/ancestry with suitable genetic data in the UK Biobank study. We used 30 independent genetic variants associated with depression as instruments. We conducted observational and two-sample MR analyses. Outcomes were employment status (employed vs not, and employed vs sickness/disability, unemployment, retirement or caring for home/family); weekly hours worked (among employed); Townsend Deprivation Index; highest educational attainment; and household income.RESULTS: People who had experienced depression had higher odds of non-employment, sickness/disability, unemployment, caring for home/family and early retirement. Depression was associated with reduced weekly hours worked, lower household income and lower educational attainment, and increased deprivation. MR analyses suggested depression liability caused increased non-employment (OR 1.16, 95% CI 1.06 to 1.26) and sickness/disability (OR 1.56, 95% CI 1.34 to 1.82), but was not causal for caring for home/family, early retirement or unemployment. There was little evidence from MR that depression affected weekly hours worked, educational attainment, household income or deprivation.CONCLUSIONS: Depression liability appears to cause increased non-employment, particularly by increasing disability. There was little evidence of depression affecting early retirement, hours worked or household income, but power was low. Effective treatment of depression might have important economic benefits to individuals and society.

U2 - 10.1136/jech-2021-218074

DO - 10.1136/jech-2021-218074

M3 - Article (Academic Journal)

C2 - 35318279

SN - 0143-005X

VL - 76

SP - 563

EP - 571

JO - Journal of Epidemiology and Community Health

JF - Journal of Epidemiology and Community Health

IS - 6

M1 - 218074

ER -

Effects of depression on employment and social outcomes: a Mendelian randomisation study

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