Employment outcomes of persons with a mental disorder and comorbid chronic pain.

Abstract

This study examined the independent and interactive effects of common mental disorders and chronic pain conditions on employment and work outcomes among individuals under 65 years old. Cross-sectional data were analyzed from the second wave of Healthcare for Communities (HCC2), a household telephone survey of U.S. civilian adults conducted in 2000-2001 (N=5,328). Common mental disorders were assessed by using the short-form version of the World Health Organization's Composite International Diagnostic Interview. Chronic pain conditions and employment outcomes were identified by self-report. Logistic and linear regression analyses were used to provide estimates for work impairment on the basis of the presence of a mental disorder or a chronic pain condition or both. The interaction between presence of a mental disorder and presence of a chronic pain condition was significantly associated with no work for pay in the past 12 months (odds ratio=2.3, 95% confidence interval=1.2-4.2) and number of days of work missed in the past month because of health (regression coefficient=1.47, SE=.59). In stratified analyses this effect persisted for women but not for men. The presence of a mental disorder and the presence of a chronic pain condition were each independently associated with limitations in work and any work missed in the past 30 days because of health, although the interaction was not significant. Mental disorders and chronic pain are each associated with work disability. Mental disorders are more strongly associated with some work disability outcomes when they are accompanied by chronic pain, especially among women.