Article Text

Download PDFPDF

Original research
Impact of depressive symptoms on worklife expectancy: a longitudinal study on Danish employees
  1. Jacob Pedersen1,
  2. Sannie Vester Thorsen1,
  3. Malene Friis Andersen1,
  4. Therese N Hanvold2,
  5. Vivi Schlünssen3,
  6. Ute Bültmann4
  1. 1 The National Research Center for the Working Environment, Copenhagen, Denmark
  2. 2 STAMI - the National Institute of Occupational Health, Oslo, Norway
  3. 3 Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
  4. 4 Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  1. Correspondence to Dr Jacob Pedersen, Nationale Forskningscenter for Arbejdsmiljo, Copenhagen 2100, Denmark; jpe{at}


Objective Depressive symptoms are associated with sickness absence, work disability and unemployment, but little is known about worklife expectancy (WLE). This study investigates the impact of depressive symptoms on the WLE of a large sample of Danish employees.

Methods We used occupational health survey data of 11 967 Danish employees from 2010 and linked them with register data on salary and transfer payments from 2010 to 2015. Depressive symptoms were self-reported using the Major Depression Inventory. We used multistate data and a life table approach with Cox proportional hazard modelling to estimate the WLE of employees, expressed by time in work, unemployment and sickness absence. Separate analyses were conducted for sex and employees with a voluntary early retirement pension scheme. Using age as time axis, we used inverse probability weights to account for differences in educational level, sector, body mass index, smoking habits and loss of employment during sickness absence.

Results The WLE of employees reporting depressive symptoms was shorter compared with those not reporting depressive symptoms; that is, the expected time in unemployment and sickness absence was longer, while the expected time in work was shorter. The shorter WLE was most pronounced in women; for example, a 40-year-old woman with depressive symptoms can expect 3.3 years less in work, 0.8 years more in unemployment and 0.7 years more in sickness absence. Employees with a voluntary early retirement pension scheme showed an even lower WLE.

Conclusions Our study showed a meaningful impact of depressive symptoms on the WLE of Danish employees using a multistate framework.

  • Worklife expectancy
  • Depression
  • Multi-state

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors JP wrote the original manuscript draft, designed the study and conducted the analysis. SVT, MFA, TNH and VS helped write the manuscript and contributed to the interpretation of the results. UB oversaw the study design and interpretation of the results, and helped write the final manuscript. The corresponding author had full access to all the data and had final responsibility to submit for publication.

  • Funding This study was funded by the Nordforsk project grant (ID: 76659) and by the National Research Centre for the Working Environment in Denmark. The funder of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval According to Danish law, research studies that use solely questionnaire and register data do not need approval from the National Committee on Health Research Ethics (Den Nationale Videnskabetiske Komité).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.