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Job insecurity and the use of antidepressant medication among Danish employees with and without a history of prolonged unemployment. A 3.5-year follow-up study
  1. Reiner Rugulies1,*,
  2. Karsten Thielen2,
  3. Else Nygaard2,
  4. Finn Diderichsen2
  1. 1 National Research Centre for the Work Environment, Denmark;
  2. 2 Department of Social Medicine, Institute of Public Health, University of Copenhagen, Denmark
  1. Correspondence to: Reiner Rugulies, National Research Centre for the Work Environment, Denmark, Lerso Parkalle 105, Copenhagen, DK-2100, Denmark; rer{at}


Background: We aimed to investigate whether job insecurity predicts incident use of antidepressant medication and whether the association is modified by a history of prolonged unemployment.

Methods: This is a prospective follow-up study with 5,142 Danish employees, including 632 employees with and 4,510 without a history of prolonged unemployment. Participants were drawn from a random 10% sample of the Danish population. We linked survey data on job insecurity with register data on a) history of unemployment and b) dispensing of antidepressant medication between June 2000 and December 2003, which we retrieved from the Danish Medicinal Product Statistics. Respondents with major depression at baseline or antidepressant use in the 5 years preceding baseline were excluded.

Results: Job insecurity predicted use of antidepressants, after adjustment for sex, age, cohabitation, socioeconomic position, and alcohol consumption (OR=1.43, 95% CI: 1.09 to 1.88). The effect was attenuated after further adjustment for baseline depressive symptoms (OR=1.15, 95% CI: 0.87 to 1.52). History of prolonged unemployment predicted use of antidepressants in both models (OR=1.62, 95% CI: 1.14 to 2.30 and OR=1.49, 95% CI: 1.04 to 2.13, respectively) Compared to participants with neither job insecurity nor unemployment history, the OR for the joint effect of job insecurity and history of prolonged unemployment was substantially higher (OR=1.79, 95% CI: 1.15 to 2.79) than the OR for job insecurity (OR=1.02) and unemployment history (OR=1.10) alone in the fully adjusted model.

Conclusion: Job insecurity predicted incident use of antidepressants among Danish employees with a history of prolonged unemployment.

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