The impact of prior psychiatric medical treatment on return to work after a diagnosis of breast cancer A registry based study

• Published in: Scandinavian journal of public health Vol. 47; no. 5; pp. 519 - 527
• Main Authors: JENSEN, LAURA SCHÄRFE, OVERGAARD, CHARLOTTE, GARNE, JENS PETER, BØGGILD, HENRIK, FONAGER, KIRSTEN
• Format: Journal Article
• Language: English
• Published: London, England Sage Publications, Ltd 01-07-2019; SAGE Publications
• Subjects: Adult; Antipsychotic Agents - therapeutic use; Breast Neoplasms - diagnosis; Cancer survivors: Beliefs, treatment, depression, and returning to work; Cohort Studies; Denmark; Female; Humans; Mental Disorders - drug therapy; Middle Aged; Registries; Return to Work - statistics & numerical data; Denmark; History of psychiatric treatment; breast cancer; cohort study; return to work
• ISSN: 1403-4948; 1651-1905
• DOI: 10.1177/1403494817722291

Purpose:
Breast cancer and psychiatric disorders negatively impact work life, both positively associated with unemployment and early retirement. Our purpose was to assess whether being prescribed psychiatric medication, 2–4 yrs prior to a diagnosis of breast cancer, could impact the likelihood of returning to work after cancer therapy.
Methods:
16,868 self-supporting women, diagnosed with breast cancer in Denmark from 2000 to 2012, were identified from a population-based clinical database, then cross-referenced to data held for psychiatric medication usage, sociodemographics, and labour-market participation. The association between historic psychiatric medication and return to work was estimated using a modified Poisson regression model. ‘Return to work’ was defined as being self-supporting one year after diagnosis of breast cancer.
Results:
16% of our cohort had used psychiatric medical treatment 2–4 years before their diagnosis. Sixty-three per cent of these individuals had returned to work one year later, compared to 69% of the patient group with no prior history of using psychiatric medication treatments. In the fully adjusted model, prior use of psychiatric medication diminished the likelihood of returning to work one year after cancer diagnosis (RR = 0.91 (0.87–0.94)). High income and older age were positively associated with returning to work; negative correlates included those related to disease severity. Conclusions: Historic use of psychiatric medication provoked a minor, although statistically significant reduction in the resumption of working life one year after a diagnosis of breast cancer. Implications for cancer survivors: Although historic use of psychiatric medication may incur a minor effect on working life, further research is needed on the long-term social consequences for sub-groups.