Abstract

Background

Understanding the prevalence of major depressive episodes (MDEs) and anxiety disorders at the population level among different labour force segments is critical to assessing and planning equitable mental health policies for Canadians adults. This study quantified prevalence trends of annually reported MDEs, anxiety disorders, and comorbid MDEs and anxiety disorders among working-age Canadians by labour force status, between 2000 and 2016.

Data and methods

This study used multiple cycles of the Canadian Community Health Survey. MDE prevalence was assessed using variants of the Composite International Diagnostic Interview and the Patient Health Questionnaire-9. Anxiety disorder prevalence captured the presence of an anxiety disorder diagnosed by a healthcare professional. Prevalence estimates were calculated in each survey cycle for three labour force groups: employed, unemployed and not participating in the labour force. A meta-analytic framework stratified by labour force status estimated prevalence trends.

Results

Between 2000 and 2016, MDE prevalence remained statistically stable over time at 5.4% (95% confidence interval [CI]: 4.7% to 6.0%), 11.7% (95% CI: 10.4% to 13.0%) and 9.8% (95% CI: 8.5% to 11.2%) among participants who were employed, unemployed, and not participating in the labour force, respectively. Anxiety prevalence ranged from 4.6% to 10.8%, and increased over time (employed: β=0.26%/year, 95% CI: 0.08% to 0.45%; unemployed: β=0.34%/year, 95% CI: -0.10% to 0.78%; not participating in the labour force: β=0.55%/year, 95% CI: 0.15% to 0.95%). Stable comorbid MDE and anxiety prevalence ranged from 1.2% to 4.1% between 2003 and 2016.

Interpretation

Trends suggest that MDE prevalence has remained stable among all labour force groups since 2000, while anxiety disorder prevalence has modestly increased since 2003. Disorder prevalence increased as labour force attachment decreased across all outcomes studied.

Keywords

depression, anxiety, mental health, labour force, prevalence, surveillance, employment, unemployment, Canada

DOI: https://www.doi.org/10.25318/82-003-x202001200002-eng

Findings

The Global Burden of Disease project reported that mental disorders have accounted for at least 14% of years of life lost due to disability since 1990. Common mental disorders—such as major depressive disorder and anxiety disorders—rank highly among the major causes of disease burden; globally, they are estimated to be associated with at least 12 billion days of lost productivity per year, costing approximately $925 billion USD. Given their high morbidity and societal cost, concerns exist that the prevalence of these common mental disorders have been increasing in developed countries over the past 30 years. [Full article]

Authors

Ms. Kathleen G. Dobson (kathleen.dobson@mail.utoronto.ca) and Dr. Cameron Mustard hold affiliations with the Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto and with the Institute for Work & Health (Toronto, Canada). Dr. Simone N. Vigod holds affiliations with Department of Psychiatry, University of Toronto and Women’s College Hospital and Research Institute (Toronto, Canada). Dr. Peter M. Smith holds affiliations with the Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto and the Institute for Work & Health (Toronto, Canada). He also holds an affiliation with the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne (Victoria, Australia).

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