{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:47:52Z","timestamp":1767833272861,"version":"3.49.0"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006636","name":"Forskningsr\u00e5det om H\u00e4lsa, Arbetsliv och V\u00e4lf\u00e4rd","doi-asserted-by":"publisher","award":["2009-1758"],"award-info":[{"award-number":["2009-1758"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The evidence is insufficient regarding the association between organizational downsizing and employee mental health. Our aim was to analyze trajectories of prescribed sedatives and anxiolytics with a sufficiently long follow-up time to capture anticipation, implementation and adaption to a downsizing event among stayers, changers and those who become unemployed compared to unexposed employees.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>Residents in Sweden aged 20\u201354 years in 2007, with stable employment between 2004 and 2007, were followed between 2005 and 2013 (n = 2,305,795). Employment at a workplace with staff reductions \u226518% between two subsequent years in 2007\u20132011 (n = 915,461) indicated exposure to, and timing of, downsizing. The unexposed (n = 1,390,334) were randomized into four corresponding sub-cohorts. With generalized estimating equations, we calculated the odds ratios (OR) of purchasing prescribed anxiolytics or sedatives within nine 12-month periods, from four years before to four years after downsizing. In order to investigate whether the groups changed their probability of purchases over time, odds ratios (OR) and their 95% confidence intervals (95% CI) were calculated contrasting the prevalence of purchases during the first and the last 12-month period within four time periods for each exposure group.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The odds of purchasing psychotropic drugs increased more for changers (sedatives OR 1.08, 95% CI 1.05\u20131.11) and unemployed (anxiolytics OR 1.08, 95% CI 1.03\u20131.14), compared to unexposed before downsizing, while for stayers purchases increased more than for unexposed during and after downsizing. Among those without previous sickness absence, stayers increased their purchases of psychotropic drugs from the year before the event up to four years after the event.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This study indicates that being exposed to downsizing is associated with increased use of sedatives and anxiolytics, before the event among those who leave, but especially thereafter for employees who stay in the organization.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0295383","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T18:30:15Z","timestamp":1702060215000},"page":"e0295383","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Downsizing and purchases of psychotropic drugs: A longitudinal study of stayers, changers and unemployed"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3933-9269","authenticated-orcid":true,"given":"Sandra","family":"Blomqvist","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Alexanderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jussi","family":"Vahtera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo","family":"Westerlund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda L.","family":"Magnusson Hanson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,12,8]]},"reference":[{"issue":"9085","key":"pone.0295383.ref001","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1016\/S0140-6736(97)03216-9","article-title":"Effect of organisational downsizing on health of employees","volume":"350","author":"J Vahtera","year":"1997","journal-title":"Lancet"},{"key":"pone.0295383.ref002","first-page":"98","article-title":"Flexible labor markets and employee health","author":"JE Ferrie","year":"2008","journal-title":"Scandinavian Journal of Work Environment & Health"},{"issue":"1","key":"pone.0295383.ref003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2190\/HS.39.1.a","article-title":"Overstretched and Unreciprocated Commitment: Reviewing Research on the Occupational Health and Safety Effects of Downsizing and Job Insecurity","volume":"39","author":"M 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A prospective longitudinal community study","volume":"102","author":"H-U Wittchen","year":"2000","journal-title":"Acta Psychiatrica Scandinavia"},{"issue":"1\u20133","key":"pone.0295383.ref016","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jad.2011.01.011","article-title":"Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies","volume":"135","author":"C Baglioni","year":"2011","journal-title":"Journal of Affective Disorders"},{"issue":"8","key":"pone.0295383.ref017","doi-asserted-by":"crossref","first-page":"e0203433","DOI":"10.1371\/journal.pone.0203433","article-title":"Downsizing and purchases of psychotropic drugs: A longitudinal study of stayers, changers and unemployed","volume":"13","author":"S Blomqvist","year":"2018","journal-title":"Plos One"},{"issue":"4","key":"pone.0295383.ref018","doi-asserted-by":"crossref","first-page":"e0285004","DOI":"10.1371\/journal.pone.0285004","article-title":"Retraction: Downsizing and purchases of psychotropic drugs: A longitudinal study of stayers, changers and unemployed","volume":"18","author":"S Blomqvist","year":"2023","journal-title":"Plos One"},{"key":"pone.0295383.ref019","article-title":"Kvinnors och m\u00e4ns arbetvillkor-betydelsen av organisatoriska faktorer och psykosocial arbetsmilj\u00f6 f\u00f6r arbets- och h\u00e4lsorelaterade utfall","author":"Swedish Work Environment Authority","year":"2016","journal-title":"Women\u2019s and Men\u2019s Working Conditions- the Importance of Organizational and Psychosocil Factors for Work and Health Related Outcomes. Stockholm Sweden"},{"issue":"1","key":"pone.0295383.ref020","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1136\/jech-2012-202294","article-title":"Job strain and depressive symptoms in men and women: a prospective study of the working population in Sweden.","volume":"68","author":"T Theorell","year":"2014","journal-title":"J Epidemiol Community Health"},{"issue":"2","key":"pone.0295383.ref021","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1111\/j.1464-0597.2007.00312.x","article-title":"Who suffers more from job insecurity? 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