The association between episodes of mental disorders and workplace injuries among employees in public university settings
Depression and anxiety are the two most prevalent mental disorders in the U.S. One third of the population experience anxiety and 17% encounter depression at least once during their lifetime. Moreover, in 2010 one in five adults used at least one prescription psychotropic drug. Employees with mental disorders pay less attention to potential hazards at work, which may lead to injury. Psychotropic drug use may increase the risk of injury through the impaired psychomotor and cognitive functions. On the other hand, after the injury, factors such as protracted wage replacement, “family problems”, delayed return to work, or loss of job may invoke further negative mental health outcomes. For the first time this study aimed to answer if there is a reciprocal longitudinal association of new episodes of depression, anxiety and psychotropic drug use with work-related injuries. The study population consisted of a retrospective cohort of employees from large southwestern university system. Three administrative datasets were linked for the plan years 2011-2013: 1) eligibility, 2) medical and prescription claims data, and 3) workers’ compensation claims file. Depression and anxiety were coded using the International Classification of Diseases – Ninth Revision (ICD-9). The national drug code (NDC) was used to identify psychotropic drug prescriptions. New episodes were defined as having a claim after an eight-week gap (56 days) between medical visits related to depression, anxiety, or psychotropic drug prescriptions. A three-wave (health plan year 2011 or T1, 2012 or T2, and 2013 or T3) autoregressive cross-lagged models were built in Mplus (v.7.4). Chi-square statistics was used to compare the fit of nested models. Logistic regression odds ratios and their 95% confidence intervals were used to assess direction and strength of associations. The findings suggest that work-related injuries at T1 increased the risk of depression by 63% and “activating” psychotropic drug use by 61% at T3. There was a reverse association observed: depression at T2 predicted hematomas, contusions, or crush injuries at T3, and hematomas, contusions, or crush injuries at T1 predicted depression at T3. There were no cross-lagged associations between anxiety and work-related injuries. Psychotropic drug prescriptions at T1 increased the risk of injury by 28% at T2. This was because of the effects of “activating” drugs. Also, psychotropic drug prescriptions at T1 increased the risk of contusions, hematomas, and crush injuries at T2 and the risk of injuries involving fixed environmental objects at T3. The reverse association where injuries involving fixed environmental objects at T1 increased the risk of psychotropic drug prescriptions at T3 was observed. Future research should incorporate broader context of work, health, and life trajectories. It is important to determine sensitive points where effective interventions could prevent from experiencing a work-related injury and future depression. Awareness about the negative effects of psychotropic drug prescriptions on work-related injuries should be increased across the occupational health and safety departments.
Mental health|Occupational health|Public health
Gerasimaviciute, Vaiva, "The association between episodes of mental disorders and workplace injuries among employees in public university settings" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10248001.