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Med."],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291718001691_sec_a1\"><jats:title>Background<\/jats:title><jats:p>The impact of obsessive\u2013compulsive disorder (OCD) on objective indicators of labour market marginalisation has not been quantified.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291718001691_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Linking various Swedish national registers, we estimated the risk of three labour market marginalisation outcomes (receipt of newly granted disability pension, long-term sickness absence and long-term unemployment) in individuals diagnosed with OCD between 2001 and 2013 who were between 16 and 64 years old at the date of the first OCD diagnosis (<jats:italic>n<\/jats:italic> = 16 267), compared with matched general population controls (<jats:italic>n<\/jats:italic> = 157 176). Hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regression models, adjusting for a number of covariates (e.g. somatic disorders) and stratifying by sex. To adjust for potential familial confounders, we further analysed data from 7905 families that included full siblings discordant for OCD.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291718001691_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Patients were more likely to receive at least one outcome of interest [adjusted HR = 3.63 (95% CI 3.53\u20133.74)], including disability pension [adjusted HR = 16.36 (95% CI 15.34\u201317.45)], being on long-term sickness absence [adjusted HR = 3.07 (95% CI 2.95\u20133.19)] and being on long-term unemployment [adjusted HR = 1.72 (95% CI 1.63\u20131.82)]. Results remained similar in the adjusted sibling comparison models. Exclusion of comorbid psychiatric disorders had a minimal impact on the results.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291718001691_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>Help-seeking individuals with OCD diagnosed in specialist care experience marked difficulties to participate in the labour market. The findings emphasise the need for cooperation between policy-makers, vocational rehabilitation and mental health services in order to design and implement specific strategies aimed at improving the patients\u2019 participation in the labour market.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291718001691","type":"journal-article","created":{"date-parts":[[2018,6,28]],"date-time":"2018-06-28T03:10:26Z","timestamp":1530155426000},"page":"1015-1024","source":"Crossref","is-referenced-by-count":52,"title":["Labour market marginalisation in obsessive\u2013compulsive disorder: a nationwide register-based sibling control study"],"prefix":"10.1017","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5059-6426","authenticated-orcid":false,"given":"Ana","family":"P\u00e9rez-Vigil","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellenor","family":"Mittendorfer-Rutz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Helgesson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Fern\u00e1ndez de la Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mataix-Cols","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,6,28]]},"reference":[{"key":"S0033291718001691_ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-009-9350-y"},{"key":"S0033291718001691_ref19","volume-title":"Transforming Disability Into Ability: Policies to Promote Work and Income Security for Disabled People","year":"2003"},{"key":"S0033291718001691_ref16","unstructured":"National Board of Health and Welfare (2013) Cause of death: 2013. 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