Mood disorders with onset in early adulthood and socio-economic outcomes over the long run

Abstract

Abstract Background Mood disorders have been associated with poor socioeconomic outcomes, but there is a lack of large-scale population-based studies on the topic. We examined associations between bipolar disorder and depression with an onset between ages 15 and 25, and subsequent socio-economic outcomes (employment, income and educational attainment) using Danish registry data. Methods All individuals (n = 2 390 127; 49% women) born in Denmark between 1955 and 1990, who were alive at their 25th birthday were included. Employment status, wage or self-employment earnings, and educational attainment were assessed annually from the age of 25 to 58 (years 1980 to 2015). Mood disorder diagnosis was obtained from the Danish Psychiatric Central Register. The associations were examined using logistic regression analyses. Results At the age of 30, 46% of individuals with bipolar disorder and 35% of individuals with depression were not employed, and 52% of individuals diagnosed with bipolar disorder and 42% of individuals with depression did not have any secondary or post-secondary education. Bipolar disorder and depression were associated with increased and increasing risk (at age 30: bipolar disorder, OR 7.21, 95% CI 6.54 to 7.96; depression, OR 4.07, 95% CI 3.93 to 4.22) of not being employed over the follow-up. Similarly, both bipolar disorder and depression were associated with increased risk of not completing secondary or post-secondary education (at the age of 30, bipolar disorder: OR 3.21, 95% CI 2.92 to 3.54; depression: OR 2.81, 95% CI 2.71 to 2.91), but this difference become smaller over the follow-up. An individual with bipolar disorder or depression earned around 36% and 51%, respectively, of the earnings earned by an individual without mood disorders. Conclusions Mood disorders diagnosed in early adulthood are associated with lasting poor socioeconomic outcomes over the long run. Key messages Early onset mood disorders are associated with consistently, and in some cases increasingly, poorer socioeconomic outcomes over time. An individual with early onset bipolar disorder or depression earned around third and half, respectively, of the earnings earned by an individual without early onset mood disorders.