Depressive symptoms and the arthritis‐employment interface. A population‐level study

Jetha A, Theis KA, Boring MA, Murphy LB, Guglielmo D. 

Arthritis Care and Research 2021; 73(1): 65-77

Published: July 2020


Objectives: To examine the relationship between depressive symptoms, arthritis, and employment participation. To determine if this relationship differs across young, middle, and older working‐age adults with arthritis.

Methods: Data from the US National Health Interview Survey, years 2013‐2017, were analyzed. Analyses were restricted to those with doctor‐diagnosed arthritis of working age (18‐64 years) with complete data on depressive symptoms (n=11,380). Covariates were sociodemographic, health, and health system use variables. Employment prevalence was compared by self‐reported depressive symptoms. We estimated percentages, univariable, and multivariable logistic regression models to examine the relationship between depression and employment among young (18‐34 years), middle (35‐54 years), and older adults (55‐64 years).

Results: Among all working‐age US adults with arthritis, prevalence of depressive symptoms was 13%. Those reporting depressive symptoms had higher prevalence of fair/poor health (60%) and arthritis‐attributable activity limitations (70%) compared with those not reporting depression (23% and 39%, respectively). Respondents with depressive symptoms reported significantly lower employment prevalence (30%) when compared with those not reporting depressive symptoms (66%) and lower multivariable‐adjusted association with employment (PR=0.88, 95% CI [confidence interval] 0.83‐0.93). Middle‐age adults reporting depression were significantly less likely to be employed compared with their counterparts without depression (PR=0.83, 95% CI 0.77‐0.90); similar but borderline statistically significant relationships were observed for both younger (PR=0.86, 95% CI 0.74‐0.99) and older adults (PR=0.94. 95% CI 0.86‐1.03).

Conclusion: For adults with arthritis, depressive symptoms are associated with not participating in employment. Strategies to reduce arthritis‐related work disability may be more effective if they simultaneously address mental health.