Labour market marginalisation in obsessive-compulsive disorder: a nationwide register-based sibling control study

Area of Science:

• Psychiatry
• Occupational Health
• Social Medicine

Background:

• Obsessive-compulsive disorder (OCD) impact on labor market participation is not well-quantified.
• Previous research has not objectively measured the association between OCD and labor market marginalization.

Purpose of the Study:

• To quantify the risk of labor market marginalization in individuals with OCD.
• To compare outcomes of disability pension, long-term sickness absence, and long-term unemployment in OCD patients versus the general population.

Main Methods:

• Utilized Swedish national registers to identify individuals diagnosed with OCD (2001-2013).
• Compared 16,267 OCD patients with 157,176 matched general population controls.
• Employed Cox regression models and sibling-discordant analyses to estimate hazard ratios, adjusting for covariates and familial confounders.

Main Results:

• Individuals with OCD had a significantly higher risk of at least one marginalization outcome (adjusted HR = 3.63).
• Specific risks included disability pension (adjusted HR = 16.36), long-term sickness absence (adjusted HR = 3.07), and long-term unemployment (adjusted HR = 1.72).
• Results were consistent in sibling comparison models, with minimal impact from comorbid psychiatric disorders.

Conclusions:

• Help-seeking individuals with OCD experience substantial labor market participation difficulties.
• Emphasizes the need for integrated strategies involving policymakers, vocational rehabilitation, and mental health services.
• Calls for specific interventions to improve labor market engagement for individuals with OCD.