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Effect of work schedule on prospective antidepressant prescriptions in Sweden: a 2-year sex-stratified analysis using national drug registry data

Amy L Hall, Göran Kecklund, Constanze Leineweber, Philip Tucker Orcid Logo

BMJ Open, Volume: 9, Issue: 1, Start page: bmjopen-2018-023247

Swansea University Author: Philip Tucker Orcid Logo

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Abstract

INTRODUCTIONDepression-related mood disorders affect millions of people worldwide and contribute to substantial morbidity and disability, yet little is known about the effects of work scheduling on depression. This study used a large Swedish survey to prospectively examine the effects of work schedu...

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Published in: BMJ Open
ISSN: 2044-6055 2044-6055
Published: 2019
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa46248
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Abstract: INTRODUCTIONDepression-related mood disorders affect millions of people worldwide and contribute to substantial morbidity and disability, yet little is known about the effects of work scheduling on depression. This study used a large Swedish survey to prospectively examine the effects of work schedule on registry-based antidepressant prescriptions in females and males over a two-year period. METHODSThe study was based on an approximately representative sample (n=3980 males, 4663 females) of gainfully employed participants in the Swedish Longitudinal Occupational Survey of Health. Sex-stratified and unstratified analyses were conducted using logistic regression. For exposure, 8 categories described work schedule in 2008: “regular days” (3 categories of night work history: none, ≤ 3 years, 4+ years), “night shift work”, “regular shift work (no nights)”, “rostered work (no nights)”, “flexible/non-regulated hours”, and “other”. For the primary outcome measure, all prescriptions coded N06A according to the Anatomical Therapeutic Chemical System were obtained from the Swedish National Prescribed Drug Register and dichotomized into “any” or “no” prescriptions between 2008 and 2010. Estimates were adjusted for potential sociodemographic, health, and work confounders, and for prior depressive symptoms.RESULTSIn 2008, 22% of females versus 19% of males worked outside of regular daytime schedule. Registered antidepressant prescription rates in the post-survey period were 11.4% for females versus 5.8% for males. In fully adjusted models, females in “flexible/non-regulated” schedules showed an increased odds ratio for prospective antidepressant prescriptions (OR=2.01, 95% CI=1.08-3.76). In males, odds ratios were most increased in those working “other” schedules (OR=1.54, 95% CI=0.93-2.56) and “Regular days with 4 or more years’ history of night work” (OR=1.72, 95% CI=0.75-3.94).CONCLUSIONSThis study’s findings support a relationship between work schedule and prospective antidepressant prescriptions in the Swedish workforce. Future research should continue to assess sex-stratified relationships, using detailed shift work exposure categories and objective registry data where possible.
Keywords: Shift work, working time, mental health, antidepressants, epidemiology
College: Faculty of Medicine, Health and Life Sciences
Issue: 1
Start Page: bmjopen-2018-023247