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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 1/2018

01-01-2018 | Original Paper

Identification of major depressive disorder among the long-term unemployed

Authors: Kirsti Nurmela, Aino Mattila, Virpi Heikkinen, Jukka Uitti, Aarne Ylinen, Pekka Virtanen

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 1/2018

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Abstract

Purpose

Depression is a common mental health disorder among the unemployed, but research on identifying their depression in health care is scarce. The present study aimed to explore the identification of major depressive disorder (MDD) in health care on long-term unemployed and find out if the duration of unemployment correlates with the risk for unidentified MDD.

Methods

The study sample consisted the patient files of long-term unemployed people (duration of unemployment 1–35 years, median 11 years), who in a screening project diagnosed with MDD (n = 243). The MDD diagnosis was found in the health care records of 101. Binomial logistic regression models were used to explore the effect of the duration of unemployment, as a discrete variable, to the identification of MDD in health care.

Results

MDD was appropriately identified in health care for 42% (n = 101) of the participants with MDD. The odds ratio for unidentified MDD in health care was 1.060 (95% confidence interval 1.011; 1.111, p = 0.016) per unemployment year. When unemployment had continued, for example, for five years the odds ratio for having unidentified MDD was 1.336. The association remained significant throughout adjustments for the set of background factors (gender, age, occupational status, marital status, homelessness, criminal record, suicide attempts, number of health care visits).

Conclusions

This study among depressed long-term unemployed people indicates that the longer the unemployment period has lasted, the more commonly these people suffer from unidentified MDD. Health services should be developed with respect to sensitivity to detect signs of depression among the long-term unemployed.
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Metadata
Title
Identification of major depressive disorder among the long-term unemployed
Authors
Kirsti Nurmela
Aino Mattila
Virpi Heikkinen
Jukka Uitti
Aarne Ylinen
Pekka Virtanen
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 1/2018
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-017-1457-y

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