Psychotropic medication before and after disability retirement by pre-retirement perceived work-related stress

Background Raising the statutory retirement age has been a common policy response to population ageing, but health problems may restrict labour force participation in older ages. We examined the development of healthy and unhealthy working life expectancies in Finland from 2000 to 2017 using different measures of health problems. Methods Healthy and unhealthy working life expectancies were calculated for the age range 50–65 years using the Sullivan method. The health measures were limiting long-standing illness, self-rated health, mental health problems and self-assessed work ability. Results Healthy working life expectancy was highest when health was measured by work ability. From 2000 to 2017, working years in full ability between the ages 50–65 increased from 6.2 (95% confidence interval 5.9–6.4) to 8.2 (8.0–8.5). Healthy working life expectancy increased also when measured by the other indicators. Unhealthy working years also increased, except when health problems were measured by limiting long-standing illness. The share of years in work increased both within the healthy and the unhealthy years, the increase being larger or equally large for the latter. Within the healthy and unhealthy years measured by the other three indicators, the share of working years increased irrespective of whether work ability was full or limited, but the increase was larger for limited work ability. Conclusions In Finland, healthy working life expectancy has increased irrespective of how health is measured but also working with health problems has become more prevalent. The estimates for healthy working years are highest when a direct measure of work ability is used.

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“…Previous studies have shown that mental strain and psychological symptoms often tend to alleviate after retirement. 30 , 31 …”

Section: Discussionmentioning

confidence: 99%

Changes in healthy and unhealthy working life expectancies among older working-age people in Finland, 2000–2017

Laaksonen

Elovainio

Sakari

et al. 2022

European Journal of Public Health

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“…Patients with a long remission period were likely to have been prescribed conventional psychotropic drugs because their symptoms subsided and a longer remission was associated with fewer prescribed psychotropic drugs and lower dosage. In addition, job-related stress which often aggravates psychopathological symptoms, decreases after retirement [ 27 ]. The dosage of prescribed psychotropic drugs can be reduced in the elderly to avoid adverse physical effects, [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Costs of psychotropics for outpatients with bipolar disorder in Japan; the MUSUBI 2016 survey

Adachi¹,

Kubota²,

Goto

et al. 2023

Annals of Medicine

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Background Although the costs of bipolar disorder (BD) treatments are associated with local and universal factors, data from non-Western countries remain limited. The associations between clinical features and costs of outpatient pharmacotherapy have not been well characterize. To estimate the costs of outpatient BD treatments and their associations with clinical features in a Japanese population, we investigated with special reference to the costs of medicines constituted the bulk of the total healthcare expense and were steadily increasing. Methods The Multicenter Treatment Survey for Bipolar Disorder (MUSUBI) retrospectively evaluated 3130 patients with BD who visited 176 Japanese psychiatric outpatient clinics in 2016. Clinical features and drug prescriptions were recorded, and the total daily costs of psychotropic drug treatment were calculated. The annual medical costs related to outpatient BD treatments in Japan were estimated based on the corresponding demographics. The associations between daily medical costs and patients’ clinical features were analyzed using multiple regression analysis. Results The daily costs of psychotropic drugs ranged from zero to JPY3245 (mean, JPY349 equivalent to USD32.5) and were exponentially distributed. The annual costs for outpatients BD treatments were approximately 51.9 billion Japanese yens (519 million US dollars). Subsequent multiple regression analysis revealed that social adjustment, depressive symptoms, age, rapid cycling, psychotic symptoms, and comorbid mental disorders correlated strongly with the daily cost of psychotropic drugs. Conclusion The estimated annual costs for outpatient BD treatment in Japan were equivalent to those in OECD countries (except for the US) and higher than those in some Asian countries. The cost of psychotropic treatments was associated with individual characteristics and psychopathological conditions. Key Messages Psychotropic treatment for an outpatient with bipolar disorder has a daily cost approximately JPY350. The annual outpatient treatment cost for bipolar disorder in Japan was estimated to 51.9 billion Japanese yen in 2016. Individual characteristics and psychopathological conditions affected the cost of drug treatment.

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“…Similarly, the decline in purchases may reflect an absence of work-related strains or fewer attempts to restore work ability. In deed, Halonen et al [36] have shown that for mental health-based disability retirees, the pre-retirement level of psychotropic drug purchases can depend on perceived preretirement work stress, while this effect attenuates after retirement. Laaksonen et al [10] respectively assume that the increase in psychotropic drug consumption among disability retirees reflects the fact that health care and pension systems identify those with disabling health problems.…”

Section: Discussionmentioning

confidence: 99%

“…For many, the decreasing amount of drug consumption probably reflects improving mental health. For awarded applicants, this may be due to reduced stress and absence of work-related strains [36,45]. For some of the awarded applicants, lowering drug purchase levels could in contrast reflect a decreasing incentive to improve functional capacity once the pension benefit is reached.…”

Section: Awarded and Rejected Applicants After The Pension Decisionmentioning

confidence: 99%

Consumption of psychotropic drugs among disability pension applicants with mental disorders: comparing awarded and rejected applicants in Finland

Perhoniemi

Tuulio‐Henriksson

Blomgren

et al. 2020

Soc Psychiatry Psychiatr Epidemiol

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Purpose Psychotropic drug consumption as a proxy measure of mental health problems during a disability pension process has only been studied among awarded applicants. This study examined psychotropic drug purchase trajectories among awarded and rejected disability pension applicants. Analyses were conducted in different diagnostic and sociodemographic groups. Methods A representative 70% sample of Finnish adults applying for disability pension due to a mental disorder in 2009-2011 (N = 18,087) was followed for 4 years in 3-month periods both before and after the pension decision. Register data on purchased drugs measured in defined daily doses (DDDs), gender, age, occupational class, unemployment history, and diagnostic group were used. The DDD levels and trends were analyzed using growth curve models. Results Psychotropic drug purchases increased before the pension decision and decreased gradually thereafter among both awarded and rejected applicants. The average DDD level was higher for rejected than awarded applicants before the decision but lower thereafter. The high pre-decision level for rejected applicants was explicit with a lower socioeconomic status. The pre-decision increase in DDDs was steeper for awarded applicants. Changes in DDDs before and after the decision were most prominent for depression, bipolar disorders, schizophrenia, and anxiety disorders. Conclusion Awarded and rejected disability pension applicants differed partly in their trajectories of psychotropic drug consumption. For awarded applicants, the steep rise of consumption prior to the award possibly reflects worsening occupational capacity. Early high consumption for rejected applicants signals long running mental health problems and calls for earlier support.

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Psychotropic medication before and after disability retirement by pre-retirement perceived work-related stress

Cited by 3 publications

References 20 publications

Changes in healthy and unhealthy working life expectancies among older working-age people in Finland, 2000–2017

Changes in healthy and unhealthy working life expectancies among older working-age people in Finland, 2000–2017

Costs of psychotropics for outpatients with bipolar disorder in Japan; the MUSUBI 2016 survey

Consumption of psychotropic drugs among disability pension applicants with mental disorders: comparing awarded and rejected applicants in Finland

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