The role of empowerment and quality of life in depression severity among unemployed people with affective disorders receiving mental healthcare

Abstract

Purpose: Sick leave and unemployment are highly prevalent among people with affective disorders. Their depression severity is disabling and inversely related to having employment. No evidence-based vocational rehabilitation exists for this target group. Knowledge is therefore needed to understand the psychosocial factors that affect depression severity in order to develop new rehabilitation interventions. This study examined relationships between depression severity and empowerment, working life aspirations, occupational engagement, and quality of life in unemployed people with affective disorders receiving mental healthcare.

Method: In this cross-sectional study of 61 participants, instruments on psychosocial factors and questions on descriptive sociodemographic and clinical characteristics were administered. Descriptive, correlation, and regression statistics were applied.

Results: Correlation and regression analyses showed significant inverse relations between depression severity and empowerment and quality of life. The odds for more severe depression decreased with higher empowerment and quality of life. However, neither extent of engagement in daily life nor working life aspiration was related to depression severity.

Conclusions: An empowerment approach and strategies, which support the quality of life, are needed in development of vocational rehabilitation interventions, and bridging of mental healthcare and vocational services.

Implications for Rehabilitation

• Enhancing empowerment and quality life in the return to work process can decrease depression severity in unemployed people with affective disorder.

• There is a need to address work issues in addition to symptom reduction in primary and mental healthcare.

• Bridging the service and time gap between vocational rehabilitation and healthcare is recommended for mitigating long-term unemployment for people with affective disorders who want to work.

Keywords:

• Depression
• bipolar disorder
• sick leave
• return to work
• vocational rehabilitation

Acknowledgements

The authors thank the participants and staff of numerous outpatient centers and Susanne Strandberg for data-collection.

Disclosure statement

The authors report no conflict of interests in relation to this paper.

Funding

The study data was funded by REHSAM [Reg. No. 2010–014], County Council of Region Skåne, and the Swedish Research Council for Health, Working Life and Welfare [Reg. No. 2010–1772].