title: Long-term effects of youth unemployment on mental health: does an economic crisis make a difference?
abstract: Ill health is a risk factor and a consequence of unemployment, which might vary depending on the national rate of unemployment. We investigated the long-term effect of youth unemployment on mental health and explored the possible interaction during periods of high (economic crisis) and low (non-crisis) unemployment rates.
  
  
  
  A register-linked population-based cohort study was conducted including individuals aged 17-24 years. The crisis cohort (n=6410) took part in the Labour Force Survey during the economic crisis (1991-1994) in Sweden and the non-crisis cohort (n=8162) took part in the same survey before the crisis (1983-1986). Follow-up was 19 years. Adjusted HRs and 95% CIs for an inpatient care discharge mental diagnosis with employed people as the reference group were calculated by Cox regressions models.
  
  
  
  In fully adjusted models, <3 months (HR: 1.69; 95% CI 1.14 to 2.49), 3-6 months (2.19; 1.43 to 3.37) and >6 months (2.70; 1.71 to 4.28) of unemployment were associated with increased risks of getting a mental diagnosis in the crisis cohort. In the non-crisis cohort the risks were: 1.92; 1.40 to 2.63, 2.60; 1.72 to 3.94 and 3.33; 2.00 to 5.57, respectively. No interactions between labour force status and level of unemployment were found.
  
  
  
  Youth unemployment is related to mental health problems, independent of the overall national rate of unemployment, which is important as the youth unemployment rates are currently at stable high level.
authors.affiliation: Child and Adolescent Public Health Epidemiology Unit, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Emelie
authors.initials: E
authors.lastname: Thern
authors.affiliation: Child and Adolescent Public Health Epidemiology Unit, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jeroen
authors.initials: J
authors.lastname: de Munter
authors.affiliation: Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.|Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Hemmingsson
authors.affiliation: Child and Adolescent Public Health Epidemiology Unit, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Health Care Services, Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
authors.forename: Finn
authors.initials: F
authors.lastname: Rasmussen
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D057172:Economic Recession; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D010415:Pensions / Q000706:statistics & numerical data; D012307:Risk Factors; D013548:Sweden; D014478:Unemployment / Q000523:psychology*; D055815:Young Adult
keywords: EPIDEMIOLOGY; MENTAL HEALTH; UNEMPLOYMENT