Sickness absence due to common mental disorders and antidepressant prescription among health and social care workers during as compared to before the COVID-19 pandemic – a nationwide register study of the Swedish population

Objectives: Essential workers, particularly in healthcare and social services were critical during the peak of the COVID-19 pandemic, yet their mental health outcomes remain understudied. We examined changes in (i) sickness absence (SA) due to common mental disorders (CMDs) and (ii) antidepressant prescription in health and social care workers during vs. pre-pandemic periods. Methods: Using Swedish national registers, we included healthcare and social workers (19 - 65 years) from 2018 to 2021. We compared quarterly incidence rate (IR) trends for SA >90 days due to CMD and antidepressant prescription across two periods: pre-pandemic (Jan 2018-Feb 2020) and during the pandemic (Mar 2020-Dec 2021) using interrupted time-series analysis. Analyses accounted for seasonality and were stratified by age, sex, and education. Results: There was no evidence of a difference in IR trends for SA >90 days or antidepressant prescription pre-pandemic vs. during the pandemic for the entire sector. However, trends of IR for antidepressant prescription increased among workers in medical laboratories (8.7% per quarter change; 4.4-13.1%), and hospitals (1.5%; 0.6-2.5%) and decreased per quarter for ambulance transports (5.4%; 0.4-1.0%). Women (10.9%; 7.2-14.7%) and highly educated individuals (10.0%; 4.1-16.1%) working in medical laboratories as well as 19-25-year-olds working in primary and dental care (7.3%; 1.7-13.1%) also experienced an increase in antidepressant prescription. Conclusions: While overall trends in SA >90 days and antidepressant prescription remained stable, certain occupational and sociodemographic groups were found to be affected in regard to antidepressant prescription. These groups warrant targeted support in future health crises.