PONE-D-19-28997

The impact of longstanding illness and common mental disorder on competing employment exits routes in older working age: a longitudinal data-linkage study in Sweden

PLOS ONE

Dear Dr. Lisa Harber-Aschan,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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ACADEMIC EDITOR: The reviewers have raised a number of points which we believe major modifications are necessary to improve the manuscript, taking into account the reviewers' remarks.  Please consider and address each of the comments raised by the reviewers before resubmitting the manuscript. This letter should not be construed as implying acceptance, as a revised version will be subject to re-review.

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We look forward to receiving your revised manuscript.

Kind regards,

Wisit Cheungpasitporn, MD, FACP

Academic Editor

PLOS ONE

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"The study was approved by the Regional Ethical Review Board in Stockholm (2016/1353-31/5). The study was a secondary data analysis which analysed data anonymously.".

i) Please amend your current ethics statement to include the full name of the ethics committee/institutional review board(s) that approved your specific study.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

Reviewer #3: No

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: In this study, authors examined the association between comorbidity types and employment exit routes. I feel interesting the findings that limiting longstanding illness, common mental disorder, and the combination differently influenced employment exit routes. I think that the sample was sufficient, and the analysis was appropriate. However, I think that authors need to clarify the definition of common mental disorder. I listed the comments to the following.

Major points

“Mental illness is also recognised as an important…” (L51)

I think that the examples of mental illness (e.g., depression, schizophrenia, etc.) help readers.

“CMD was captured using the 12-item General Health Questionnaire (GHQ-12), a screen assessing symptoms of psychological distress” (L95-96)

GHQ-12 is a screening tool, which can not elucidate accurate diagnosis. Thus, the points should be added to the limitation section. In addition, CMD is a broad concept, whereas GHQ-12 can not capture all of CMD. For example, I think that GHQ-12 was not related to schizophrenia and dementia. I think that authors should describe the definition of CMD in this study.

Minor points

“and was recently was found to be specifically associated with unemployment in” (L52)

Exclude the second “was” in the sentence.

Reviewer #2: The subject and the matter are an ongoing issue in modern society which is directly affecting the mental health state and physical health of the relevant population and also their families and colleagues.

This subject is covering not only mental health but also the socio-economic aspects of employment and also occupational health. I as a psychiatrist would like to see more work form the authors with possibility of same studies in different countries.

Reviewer #3: The authors have identified good problem. I suggest to include the following points in your statistical analysis:

1) Graphical representation of the results.

2) regression analysis should also be included.

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Reviewer #1: No

Reviewer #2: Yes: Dr Lily Abedipour MD

Reviewer #3: No

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The impact of longstanding illness and common mental disorder on competing employment exits routes in older working age: a longitudinal data-linkage study in Sweden

PONE-D-19-28997R1

Dear Dr. Lisa Harber-Aschan,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

With kind regards,

Wisit Cheungpasitporn, MD, FACP

Academic Editor

PLOS ONE

Additional Editor Comments:

I reviewed the revised manuscript and the response to reviewers' comments. Revised Manuscript is well written. All comments have been addressed and thus accepted for publication.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

Reviewer #4: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

Reviewer #4: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: I Don't Know

Reviewer #4: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

Reviewer #4: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

Reviewer #4: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: It seems that the authors have addressed the outlined issues and have also added further explanations.

Reviewer #4: I have no competing interests. I thank the author(s) for addressing questions and concerns. Given the changes made and the major concerns being addressed, I have no further reservations regarding publication of the revised version of the manuscript.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: Yes: Dr Lily Abedipour MD

Reviewer #4: No