Article Text

Download PDFPDF
Original research
Prevalence and risk factors for anxiety and depression disorders in workers with work-related musculoskeletal strain or sprain in British Columbia, Canada: a comparison of men and women using administrative health data
  1. Andrea Marie Jones1,
  2. Mieke Koehoorn1,
  3. Ute Bültmann2,
  4. Christopher B McLeod1,3
  1. 1School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  3. 3Institute for Work and Health, Toronto, Ontario, Canada
  1. Correspondence to Dr Andrea Marie Jones, School of Population and Public Health, The University of British Columbia, Vancouver, V6T 1Z3, Canada; andrea.jones{at}


Objective To examine the prevalence and risk factors for medically treated anxiety and depression disorders among men and women with musculoskeletal strain or sprain work injury in British Columbia, Canada.

Methods A retrospective population-based cohort of accepted workers’ compensation lost-time claims from 2000 to 2013 was constructed using linked administrative health data. Anxiety and depression disorders were identified using diagnoses from physician, hospital and pharmaceutical records. The 1-year period prevalence was estimated for the year before and the year after injury. Sociodemographic, clinical and work-related risk factors for prevalent and new onset anxiety and depression disorders were examined using multinomial regression.

Results 13.2% of men and 29.8% of women had medically treated anxiety, depression or both in the year before injury. Only a slight increase (~2%) in the prevalence of these disorders was observed in the year after injury. Somatic and mental comorbidities were both strong risk factors for pre-existing and new onset anxiety and depression for both men and women, but these relationships were stronger for men.

Conclusion Anxiety and depression disorders including those from prior to injury are common in workers with musculoskeletal strain or sprain and are associated with a complicated clinical profile. Gender-sensitive and sex-sensitive mental healthcare is an important consideration for work disability management.

  • epidemiology
  • mental health
  • musculoskeletal
  • disability
  • longitudinal studies

Statistics from


  • Contributors All authors contributed to the study conception and design. Data cleaning and analyses were performed by AMJ. The first draft of the manuscript was written by AMJ and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

  • Funding AMJ was supported by a WorkSafeBC Research Training Award, Centre for Research on Work Disability Policy Student Trainee Award, and Bridge CIHR Strategic Training Fellowship. MK was supported in part by a CIHR Chair in Gender, Work and Health. CM was supported by a CIHR New Investigator Award and is supported by a MSFHR Scholar Award.

  • Disclaimer All inferences, opinions and conclusions drawn in this paper are those of the authors, and do not reflect the opinions or policies of the Data Stewards.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was obtained from the Behavioural Research Ethics Board at the University of British Columbia (H15-02150).

  • 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. The health claims data used for this study were made available to the researchers by Population Data BC ( with permission from the data stewards. The data was made available for the sole purposes of achieving the research objectives and is not available for sharing.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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.