Lifetime major depressive disorder and work-to-retirement trajectories in the Netherlands

Background

While physical health is a well-known determinant of the retirement transition, evidence on mental health is limited, but needed, as the mental health history may shape long‑term employment trajectories. This study aims to examine the association between lifetime depression and work‑to‑retirement trajectories using linked cohort and administrative register data.

Methods

Sequence analysis was applied to work history data from Statistics Netherlands to identify clusters of work-to-retirement trajectories covering five years before and one year after the statutory retirement age. Lifetime major depressive disorder was assessed using the Mini International Neuropsychiatric Interview (MINI) in the Lifelines Cohort Study. Associations between lifetime depression and work-to-retirement trajectories were examined using multinomial logistic regression, adjusting for gender, educational attainment and cohort.

Results

The sample included 14,784 participants born 1938–1956. We identified six work-to-retirement groups: early retirement (26%), employment until formal retirement age (38%), sick leave/disability (8%), no income (15%), self-employed (8%) and unemployed (5%). Multinomial logistic regression showed that individuals with a history of depression were more likely to belong not only to sick leave/disability group (OR = 2.92, p < 0.001) but also to the early retirement (OR = 1.29, p < 0.001) and unemployed (OR = 1.48, p < 0.001) groups compared to the reference group of employment until formal retirement age, even after adjustment for potential confounders.

Conclusions

Lifetime major depressive disorder is associated with distinct work-to-retirement trajectories. Our findings highlight the importance of a life course perspective on mental health and work experiences and emphasise the need for preventive and supportive interventions for people with mental health problems throughout the working life course.

Key messages

• Lifetime major depressive disorder is associated with distinct work-to-retirement trajectories, suggesting that mental health has long-term consequences for labour market transitions.

• A life course approach is needed to better understand the work-to-retirement transition and the impact of mental health on employment.