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Effects of depression on employment and social outcomes: a Mendelian randomisation study

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Desmond Campbell, Michael James Green, Neil Davies, Evangelia Demou, Laura D Howe, Sean Harrison, Daniel J Smith, David M Howard, Marcus Munafo, Srinivasa Vittal Katikireddi, Andrew M McIntosh

Original languageEnglish
Article number218074
Pages (from-to)563-571
Number of pages9
JournalJournal of Epidemiology and Community Health
Volume76
Issue number6
DOIs
Accepted/In press8 Feb 2022
Published1 Jun 2022

Bibliographical note

Funding Information: Funding This study was conducted using data from the UK Biobank resource (application number 17333). This work is part of a project entitled ’Social and Eonomic Consequences of Health: Causal Inference Methods and Longitudinal, Intergenerational Data’, which is part of the Health Foundation’s Social and Economic Value of Health Programme (grant ref. 807293). The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. This work was further supported by the Medical Research Council (DC, MG, ED and SVK, grant ref. MC_UU_00022/2) and the Scottish Government Chief Scientist Office (DC, MG, ED and SVK, grant ref. SPHSU17), an NHS Research Scotland (NRS) Senior Clinical Fellowship (SVK, grant ref. SCAF/15/02), an Economics and Social Research Council (ESRC) Future Research Leaders grant (NMD, grant ref. ES/N000757/1), a Norwegian Research Council (NMD, grant ref. 295989), a Career Development Award from the UK Medical Research Council (LDH, grant ref. MR/M020894/1), a MRC Strategic Award (ED, grant ref. MRC_PC_13027), a Sir Henry Wellcome Postdoctoral Fellowship (DMH, grant ref. 213674/Z/18/Z), a Brain & Behavior Research Foundation 2018 NARSAD Young Investigator Grant (DMH, grant ref. 27404), the Medical Research Centre Integrative Epidemiology Unit at the University of Bristol (MM, grant ref. MC_UU_0011/1, MC_UU_0011/7), Medical Research Centre grant (AMM, grant ref. MC_PC_17209) and Wellcome Trust grants (AMM, grant ref.s 104036/Z/14/Z, 220857/Z/20/Z). Funding Information: Competing interests SVK reports grants from the Medical Research Council, the Health Foundation and the Scottish Government Chief Scientist Office during the conduct of this study. Publisher Copyright: © 2022 Authors.

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Abstract

Background Depression is associated with socioeconomic disadvantage. However, whether and how depression exerts a causal effect on employment remains unclear. We used Mendelian randomisation (MR) to investigate whether depression affects employment and related outcomes in the UK Biobank dataset.

Methods We selected 227 242 working-age participants (40–64 in men, 40–59 years for women) of white British ethnicity/ancestry with suitable genetic data in the UK Biobank study. We used 30 independent genetic variants associated with depression as instruments. We conducted observational and two-sample MR analyses. Outcomes were employment status (employed vs not, and employed vs sickness/disability, unemployment, retirement or caring for home/family); weekly hours worked (among employed); Townsend Deprivation Index; highest educational attainment; and household income.

Results
People who had experienced depression had higher odds of non-employment, sickness/disability, unemployment, caring for home/family and early retirement. Depression was associated with reduced weekly hours worked, lower household income and lower educational attainment, and increased deprivation. MR analyses suggested depression liability caused increased non-employment (OR 1.16, 95% CI 1.06 to 1.26) and sickness/disability (OR 1.56, 95% CI 1.34 to 1.82), but was not causal for caring for home/family, early retirement or unemployment. There was little evidence from MR that depression affected weekly hours worked, educational attainment, household income or deprivation.

Conclusions Depression liability appears to cause increased non-employment, particularly by increasing disability. There was little evidence of depression affecting early retirement, hours worked or household income, but power was low. Effective treatment of depression might have important economic benefits to individuals and society.

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