title: Long-term effects of mental disorders on employment in the National Comorbidity Survey ten-year follow-up.
abstract: OBJECTIVE
  Although significant negative associations of mental disorders with employment have been documented in epidemiological research, much of this research was based on cross-sectional samples and focused only on severe and persistent mental disorders. The present study examined the longitudinal associations of more common mental disorders with employment.
  
  
  METHODS
  Data on the associations of common mental disorders with employment are presented here from 4501 respondents in the National Comorbidity Survey panel study, a two-wave community epidemiological survey of respondents aged 15-54 at baseline (1990-1992) who were re-interviewed in 2001-2003 and were employed, unemployed in the labor force or student at baseline. Lifetime mental disorders at baseline and disorders with onset after baseline were assessed with the Composite International Diagnostic Interview, a fully structured interview that assessed lifetime prevalence of internalizing fear disorders (panic, phobias), anxiety/misery disorders (major depression, generalized anxiety disorder, post-traumatic stress disorder), externalizing disorders (conduct disorder, alcohol and illicit drug abuse-dependence), and bipolar disorder.
  
  
  RESULTS
  Both baseline lifetime disorders and disorders with onsets after baseline were associated with significantly reduced odds of subsequent employment among respondents who were either employed or students at baseline. Population projections based on the assumption that these associations represented causal effects suggest that the mental disorders considered here were associated with 1.7-3.2 million adults being unemployed in the US population at follow-up.
  
  
  CONCLUSIONS
  Expanded access to treatment among current employees and students with mental disorders might lead to improved employment outcomes in these segments of the population.
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA. rmojtab1@jhu.edu.
authors.forename: Ramin
authors.initials: R
authors.lastname: Mojtabai
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stuart
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Irving
authors.initials: I
authors.lastname: Hwang
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Susukida
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Eaton
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Sampson
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Disability; Employment; Epidemiological survey; Impairment in functioning