Little is known about gender differences in the association between occupational injury and depression. We investigated the bidirectional association and gender differences between work-related injury and depression using the same cohort in the US Medical Expenditure Panel Survey (MEPS). In Analysis 1, the association of occupational injury and subsequent depression was investigated from 35,155 employees without depression. Analysis 2 included 32,355 participants without previous injury and examined the association of depression and work-related injury. The multivariable-adjusted odds ratio was estimated using a discrete time-proportional odds model. Male workers who had experienced workplace injury were more vulnerable to post-injury depression than non-injured male workers (OR = 2.35, 95% CI: 1.52, 3.65). Female workers with depression were more prone to get injured at the workplace than the non-depressed female workers (OR = 1.44, 95% CI: 1.07, 1.96). These results did not hold in the reverse direction for both genders. Workers compensation benefit was positively associated with the risk of post-injury depression among males, whereas anti-depressant medication and duration of depression were related to workplace injury among females. Gender differences in the direction and associated factors of the relationship between occupational injury and depression highlight the need for gender-specific intervention to the vicious cycle of workplace injury and depression.
Keywords: bidirectional association; depression; gender; longitudinal study; occupational injury.