Disability pension and everyday life: A period of transition and subjective aspects of future occupational life

ObjectiveAdverse health outcomes, including suicide, in individuals on disability pension (DP) due to mental diagnoses have been reported. However, scientific knowledge on possible risk factors for suicidal behaviour (suicide attempt and suicide) in this group, such as age, gender, underlying DP diagnoses, comorbidity and DP duration and grade, is surprisingly sparse. This study aimed to investigate associations of different measures (main and secondary diagnoses, duration and grade) of DP due to common mental disorders (CMD) with subsequent suicidal behaviour, considering gender and age differences.DesignPopulation-based prospective cohort study based on Swedish nationwide registers.MethodsA cohort of 46 515 individuals aged 19–64 years on DP due to CMD throughout 2005 was followed-up for 5 years. In relation to different measures of DP, univariate and multivariate HRs and 95% CIs for suicidal behaviour were estimated by Cox regression. All analyses were stratified by gender and age.ResultsDuring 2006–2010, 1036 (2.2%) individuals attempted and 207 (0.5%) completed suicide. Multivariate analyses showed that a main DP diagnosis of ‘stress-related mental disorders’ was associated with a lower risk of subsequent suicidal behaviour than ‘depressive disorders’ (HR range 0.4–0.7). Substance abuse or personality disorders as a secondary DP diagnosis predicted suicide attempt in all subgroups (HR range 1.4–2.3) and suicide in women and younger individuals (HR range 2.6–3.3). Full-time DP was associated with a higher risk of suicide attempt compared with part-time DP in women and both age groups (HR range 1.4–1.7).ConclusionsDepressive disorders as the main DP diagnosis and substance abuse or personality disorders as the secondary DP diagnosis were risk markers for subsequent suicidal behaviour in individuals on DP due to CMD. Particular attention should be paid to younger individuals on DP due to anxiety disorders because of the higher suicide risk.

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“… 10 Similarly, part-time DP might be more protective concerning such adverse health or social outcomes than full-time DP. 11 12 …”

Section: Introductionmentioning

confidence: 99%

Disability pension due to common mental disorders and subsequent suicidal behaviour: a population-based prospective cohort study

et al. 2016

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Participation in the workforce after a traumatic brain injury: a matter of control

Johansson

Haugstad

Berg

et al. 2015

Disability and Rehabilitation

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Two years after injury, the participants remained uncertain about their abilities with respect to what was expected of them at work. The participants felt they would do better as time progressed. The participants, wanting to control their own improvement, sought counselling to help sort out their priorities and found it could contribute to help with their progress in finding a suitable balance between daily activities and work. A consequence of our main finding, in a multidisciplinary context, is that counselling in structures and routines with respect to work-related tasks should be considered to be an integral part of any rehabilitation programme after TBI.

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Associations between prognosed future work capacity among long-term sickness absentees and their actual work incapacity two years later

Lundh

Gustafsson

Linder

et al. 2014

Work

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BACKGROUND: Studies indicate that long-term sickness absence reduces the ability to return to work (RTW). Multidisciplinary medical assessments (MMA) have been used as a method to receive a more versatile assessment of long-term sickness absentees (LTSA) and thereby a better basis for adequate medical and vocational rehabilitation, and an increasing ability to maintain or regain work capacity. OBJECTIVE: The objective of this study was to investigate the associations between the prognoses of LTSAs' future work capacity made at a MMA and the assessments of their work incapacity made by the Social Insurance Offices (SIO) two years later. PARTICIPANTS: 385 LTSAs referred to an MMA by SIOs in the Stockholm area in Sweden between 2001 and 2006. METHODS: Data was collected at the MMA on demographic factors, health, diagnoses, and future work capacity. Information on SIO decisions on sickness benefits and disability pension and what measures the SIO had taken was extracted from the case files at the SIOs. Descriptive statistics and multiple regression analyses were used to assess the associations between the prognosis and decisions on benefits, controlling for individual factors. RESULTS: Of those predicted to be able to maintain or regain work capacity, 68% received full-time benefits two years later. Work capacity was negatively affected by high age, full time sickness absence at MMA and number of physical symptoms at MMA. The prognosis at the MMA was not significantly related to work capacity when socio-demographic and health factors were controlled for. However, this was partly due to the fact that the MMA also included recommendations for vocational rehabilitation and that this factor had an effect on assessed work incapacity after two years. CONCLUSION: The prognosis of future work capacity evaluated at a multidisciplinary medical assessment correlated with actual work capacity two years later. However, a range of other factors were decisive for the result. The study shows that the link between the prognosis and recommendations for vocational rehabilitation should be followed by the SIOs responsible for enhancing RTW among individuals on long-term sick leave.

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Disability pension and everyday life: A period of transition and subjective aspects of future occupational life

Cited by 3 publications

References 17 publications

Disability pension due to common mental disorders and subsequent suicidal behaviour: a population-based prospective cohort study

Disability pension due to common mental disorders and subsequent suicidal behaviour: a population-based prospective cohort study

Participation in the workforce after a traumatic brain injury: a matter of control

Associations between prognosed future work capacity among long-term sickness absentees and their actual work incapacity two years later

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