Depression is a common disorder among the unemployed, but research on identification of their depression in health care (HC) is scarce.

The present study aimed to find out if the duration of unemployment correlates to the risk for unidentified major depressive disorder (MDD) in HC.

Sample of the study consisted of long-term unemployed who were in screening project diagnosed as having MDD (n = 243). The diagnosis was found in the records of HC in 101 (42%) and not found in 142 (58%) individuals. Binary logistic regression models were used to explore the effect of the duration of unemployment to the identification of MDD in HC.

The odds ratio (OR) for non-identified MDD in HC was 1.060 (95%CI 1.011–1.111, P = 0.016) per unemployment year and when unemployment had continued, for example, five years the OR for unidentified MDD was 1.336. The association remained significant throughout adjustments for the set of background factors (gender, age, occupational status, marital status, homelessness, self-reported criminal records, suicide attempts, number of HC-visits).

This study among depressed long-term unemployed indicates that the longer the unemployment period has lasted, the greater the risk for non-identification of MDD is. HC services should be developed with respect to sensitivity to detect signs of depression among long-term unemployed.

The authors have not supplied their declaration of competing interest.