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

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

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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.

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.
Original languageEnglish
Article number218074
Pages (from-to)563-571
Number of pages9
JournalJournal of Epidemiology and Community Health
Issue number6
Publication statusPublished - 1 Jun 2022


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