Abstract
Objectives: The study investigated initiation of psychotropic medication in relation to unemployment in the months before, during and after job loss to detect the period of greatest risk.
Methods: The Norwegian working population in 2004 (N=2 348 552) was observed from 2005 to 2010 through administrative registries linked to the Norwegian Prescription Database. A casecrossover design was used to analyse within-person relative risk of incident purchases of prescribed psychotropic drugs in relation to timing of unemployment. Control periods were defined 12, 24 and 36 months before the drug purchase. Supplementary analyses were performed on medication for cardiovascular disease, diabetes, obesity, thyroid disorder, pain and musculoskeletal conditions.
Results: Purchases of all psychotropic drugs increased 1-3 months before job loss. Antidepressants had the highest estimate in the month before job loss (odds ratio (OR) 2.68, 95% confidence intervals (CI) 2.39 to 3.01), followed by hypnotics/sedatives (OR 2.21, 95% CI 1.97 to 2.48), anxiolytics (OR 2.18, 95% CI 1.91 to 2.48) and antipsychotics (OR 2.09, 95% CI 1.76 to 2.48). Rises were greatest in males. Risk of starting psychotropic medication remained raised during a spell of unemployment, but returned to close to baseline levels following re-employment. Drugs used to treat somatic and pain conditions showed similar trends but with weaker associations.
Conclusions: Concerns about impending unemployment may influence mental health several months prior to job loss, especially around the time of notification. The clinical implications of this might be a strengthening of preventive health initiatives early in the unemployment process
Methods: The Norwegian working population in 2004 (N=2 348 552) was observed from 2005 to 2010 through administrative registries linked to the Norwegian Prescription Database. A casecrossover design was used to analyse within-person relative risk of incident purchases of prescribed psychotropic drugs in relation to timing of unemployment. Control periods were defined 12, 24 and 36 months before the drug purchase. Supplementary analyses were performed on medication for cardiovascular disease, diabetes, obesity, thyroid disorder, pain and musculoskeletal conditions.
Results: Purchases of all psychotropic drugs increased 1-3 months before job loss. Antidepressants had the highest estimate in the month before job loss (odds ratio (OR) 2.68, 95% confidence intervals (CI) 2.39 to 3.01), followed by hypnotics/sedatives (OR 2.21, 95% CI 1.97 to 2.48), anxiolytics (OR 2.18, 95% CI 1.91 to 2.48) and antipsychotics (OR 2.09, 95% CI 1.76 to 2.48). Rises were greatest in males. Risk of starting psychotropic medication remained raised during a spell of unemployment, but returned to close to baseline levels following re-employment. Drugs used to treat somatic and pain conditions showed similar trends but with weaker associations.
Conclusions: Concerns about impending unemployment may influence mental health several months prior to job loss, especially around the time of notification. The clinical implications of this might be a strengthening of preventive health initiatives early in the unemployment process
| Original language | English |
|---|---|
| Article number | 726 |
| Number of pages | 59 |
| Journal | Occupational and Environmental Medicine |
| Volume | 73 |
| Issue number | 11 |
| Early online date | 14 Oct 2016 |
| DOIs | |
| Publication status | Published - 1 Nov 2016 |
Research Groups and Themes
- SASH
Keywords
- Depression
- Mental Health
- Job insecurity
Access to Document
- Full-text PDF (accepted author manuscript)
This is the accepted author manuscript (AAM). The final published version (version of record) is available online via BMJ Publishing Group at http://dx.doi.org/10.1136/oemed-2016-103578. Please refer to any applicable terms of use of the publisher.