Survival analysis of anxiety and depression among patients with occupational diseases: A nationwide case-control study

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Jong-Yi Wang and Jen-De Chen

China Medical University, Taiwan
National Changhua University of Education, Taiwan

: J Trauma Stress Disor

Abstract

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Patients with occupational diseases are psychiatrically vulnerable. However, a time-dependent model predicting anxiety and depression specific for this population is unexplored. Therefore, this study investigated the risk of mental disorders and the duration until the onset of mental disorders after occupational disease diagnosis in patients with occupational diseases. This retrospective study employed the 2002-2013 Taiwan National Health Insurance Research Database. A total of 18,285 patients with occupational disease and injury were identified. The case and control groups were randomly matched by gender, age, urbanization level, comorbidity and the index year of occupational illness through 1:1 propensity score matching. The statistical methods included logistic regression and Cox proportional hazard model. All analysis was conducted in SAS 9.3. The determined prevalence rate of mental disorders subsequent to occupational diseases was 8.17%; the most prevalent disorder was anxiety (2.79%); the prevalence rate of depression was 0.94%. The average time interval required for mental disorder onset identified using survival analysis was 9.51 months. Characteristics associated with higher odds of mental disorders included women, high age, low income, high comorbidity and clinic and public hospital care users (all P<0.05). Odds of mental disorders were significantly higher among patients with occupational diseases than patients without such diseases (OR=1.098, P=0.0315). Patients with occupational diseases have a high risk in anxiety, depression and other disorders. Health care organizations should expand integrative care framework to this vulnerable group and target high risk patients for timely intervention, preferably within 5 months after the diagnosis of occupational diseases.

Biography

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Jong-Yi Wang completed his PhD from University of South Carolina and postdoctoral studies from South Carolina Rural Health Research Center. He is an associated professor in the Department of Health Services Administration, China Medical University, Taiwan. He has published nearly 20 SCI/SSCI papers in reputed journals. His specialities include mental health, health policy, health promotion, health disparities and health care quality. Jen-De Chen received her PhD from University of South Carolina. She specialized in counseling and psychiatric rehabilitation.

Email: ericwang@mail.cmu.edu.tw