The Influence of Lifetime Mood Disorders on Current Self-Assessed Employment Difficulties Using the National Comorbidity Survey Replication

Background and Purpose:This study aims to understand the degree to which those who ever had a mood disorder (“lifetime”) affects current difficulties at work, and how factors identified in previous research (gender, marital status, difficulties in daily living, physical discomfort) affect this relationship.

Methods: Data from the National Comorbidity Survey Replication (NCS-R, 2001-2003) was used. Participants who had valid responses on all variables in the model were included (n=3230). The final sample consisted of n=1760 females (54.5%) and n=1470 males (45.5%), with a mean age of 39.38 (sd=12.97). Respondents were divided by those who do (n=1127) and do not (n=2103) have lifetime mood disorders.  Gender, marital status, and physical discomfort were included as possible moderating variables. Additionally, difficulties in daily living was measured by totaling six yes/no items (m=.424, sd=.979; α=.721).  Difficulties at work in the past month was measured using nine questions assessing the frequency of work difficulties. Questions were measured on a 5-point scale (0=None of the time to 4=All of the time). Responses were totaled (m=32.19, sd=3.56), where higher scores indicated more frequent difficulties. Cronbach’s alpha for the measure was acceptable (α=.745).

Results:No significant differences were found between those with and without mood disorders on several demographic variables (number of years of education, race, age, and household income). Chi-square tests indicated those with mood disorders were more likely to be divorced/separated/widowed, and less likely to be married/cohabiting (χ2(df=2)=46.11, p<.001). Assessment of gender indicated that females were more likely to have a lifetime mood disorder than males (χ2(df=1)=48.46, p<.001). Significant differences also existed between those with and without mood disorders on difficulties in daily living (t(df=1538.93)= -12.11, p<.001) and physical discomfort (t(df=2079.36)= -7.98, p<.001). Using hierarchical regression, the first step assessed the relationship between lifetime mood disorder and current difficulties at work (F(1,3228)=84.82, p<.001), which explained 2.6% of variance in the model. Difficulties in daily living, physical discomfort, and gender were added in step 2 (F(3,3225)=69.19, p<.001), which explained a further 8.5% of variance. Finally, marital status was added in step three (F(2,3223)=17.50, p<.001), explaining an additional 9.4% of variance. Presence or absence of a mood disorder was significant at the p<.001 level throughout, as were difficulties in daily living and physical discomfort. Gender was significant (p<.01) in both steps 2 and 3. If the respondent had never been married significantly contributed to the model (p<.001); however, being divorced/separated/widowed did not (p>.05).

Conclusions and Implications: Significant differences exist between those with and without lifetime mood disorders on current work difficulties. Factors previously identified as influencing employment difficulties also significantly contributed to this model. Practitioners and employment specialists should consider giving extra support to employed clients who have ever had a mood disorder. Additionally, future research should compare current employment outcomes between those who have ever had a mood disorder with those more recently experiencing mood disorders. These differences may also be explored across type of mood disorder, in order to develop effective employment support interventions.