Association of mood, anxiety, and substance use disorders with occupational status and disability in a community sample

This study examined associations between mood disorders, anxiety disorders, substance dependence or harmful alcohol use, and occupational status and disability in a general population sample.

Data from the Canadian Community Health Survey Cycle 1.2-Mental Health and Well-Being (CCHS-1.2), a representative cross-sectional survey, were analyzed. The total sample was narrowed to individuals between the ages of 18 and 64 years, the age range most likely to be working.

Of the 27,332 persons surveyed, 946 had a mood disorder only, 831 had an anxiety disorder only, 730 had substance dependence only, and 966 had more than one disorder. Twenty-three percent reported that during the previous week they were not at a job or were permanently unable to work (27% with mood disorder only, 30% with anxiety disorder only, and 20% with substance dependence only, and 34% with more than one disorder). In unadjusted analyses, mood and anxiety disorders were associated with absence from work during the week preceding the interview, whereas substance dependence was not. After adjustment for other variables using logistic regression, an association of substance dependence and work absence emerged. Each category of disorder was strongly associated with a greater likelihood of disability days or days spent in bed for mental health reasons.

On a population level, mood and anxiety disorders and substance dependence were associated both with not working during the week preceding the interview as well as an increase in reported disability or bed days. The strength of association appears to be stronger for mood and anxiety disorders.