scholarly journals The importance of clinical and labour market histories in psychiatric disability retirement: analysis of the comprehensive Finnish national-level RETIRE data

2019 ◽  
Vol 55 (8) ◽  
pp. 1011-1020 ◽  
Author(s):  
S. Pirkola ◽  
J. Nevalainen ◽  
M. Laaksonen ◽  
S. Fröjd ◽  
K. Nurmela ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Labour Market ◽  
Work Ability ◽  
Disability Pension ◽  
National Level ◽  
Psychiatric Disability ◽  
Permanent Disability ◽  
Returning To Work ◽  
Age And Sex

Abstract Objectives Despite the stable incidence of mental disorders in Finland and Europe, mental health-related occupational disability has been increasing. We unveiled the paths to permanent psychiatric disability, recovery, or death, by analysing sequences of labour market participation. Methods The RETIRE register database includes information regarding all persons (n = 42,170) awarded an ICD-10 psychiatric disability pension between 2010 and 2015 in Finland. We identified clusters of typical paths of pre-retirement labour market history. Controlling for major mental disorders, age, and sex, we evaluated factors associated with returning to work (RTW), or death, over a 5-year follow-up period. Results Only 10.5% of the disabled subjects returned to work within the follow-up. Half of them ended up with a permanent disability pension. Seven distinguishable paths to disability were identified. Subjects in the cluster characterized by steady employment were relatively often females, lost their work ability due to affective disorders, and had the highest rate of returning to work (16.3%). Mortality was highest (9%) among the cluster characterized by long-term unemployment. Distributions of major diagnostic groups, as well as age and sex, differed between clusters. After their adjustment in the analysis of RTW or death, the identified labour market history paths prior to losing work ability remained as important independent prognostic factors for both outcomes. Conclusions The complex retirement process involves identifiable clinical and contextual associating factors. Labour market history patterns associate with varying prognoses after psychiatric retirement. Prolonged unemployment appears as a predictor of relatively poor prognoses, whereas employment indicates the opposite.

scholarly journals Does seeing a psychologist reduce sickness absence due to mental disorders? A quasi-experiment

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Lahti ◽  
J Harkko ◽  
H Sumanen ◽  
K Piha ◽  
O Pietiläinen ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Sickness Absence ◽  
Work Ability ◽  
Early Stage ◽  
Matched Sample ◽  
Full Sample ◽  
Common Support ◽  
The City ◽  
Quasi Experiment

Abstract Background Mental ill-health in young adults is a major public health and work-life problem. We examined in a quasi-experimental design whether occupational psychologist appointment can reduce subsequent sickness absence due to mental disorders among young Finnish employees. Methods The present study was conducted among 18-39-year-old employees of the City of Helsinki using register data from the City of Helsinki and the Social lnsurance Institution of Finland. We used Wald test to compare the differences in sickness absence days due to mental disorders (ICD-10, F-diagnosed) between those treated (occupational psychologist appointment for work ability support) and the non-treated (no psychologist appointment) during a one year follow-up. The full sample (n = 2156, 84% women) consisted of employees with mental disorder diagnosed sickness absence during 2009-2014. To account for the systematic differences between the treated and non-treated, the participants were matched according to their characteristics (age, sex, occupational class, education, previous sickness absence and psychotropic medication). The matched sample included 886 participants. We excluded those with treatment before the treatment screening time (± 3 months to the end of sickness absence period), non-treated with treatment during the follow-up and those that could not be matched (lack of common support). Results In the full sample, the mean of sickness absence days due to mental disorders was 17.7 (95% CI, 11.4, 24.1) days for those treated (n = 240) and 23.2 (95% CI, 20.5, 25.9) days for non-treated (n = 1916), difference being non-significant. The corresponding figures in the matched sample were (16.8, 95% CI, 9.5-24.1) for those treated (n = 195) and (27.8, 95% CI, 22.6-32.9) for non-treated (n = 691), difference being statistically significant (p = 0.02). Conclusions This quasi-experiment suggests that seeing an occupational psychologist to support work ability may be reduce mental health related sickness absence. Key messages We showed that supporting work ability at an early stage may prevent sickness absence due to mental disorders. More efforts to provide early stage support for maintaining work ability may prove useful in reducing sickness absence rates in younger employees.

scholarly journals Work ability score and future work ability as predictors of register-based disability pension and long-term sickness absence: A three-year follow-up study

2017 ◽  
Vol 46 (3) ◽  
pp. 321-330 ◽  
Author(s):  
Ulla Kinnunen ◽  
Jouko Nätti
Keyword(s):  
Sickness Absence ◽  
Work Ability ◽  
Disability Pension ◽  
Negative Binomial ◽  
Work Ability Index ◽  
Rate Ratios ◽  
Future Work ◽  
Work Ability Score

Aims: We investigated two single items of the Work Ability Index – work ability score, and future work ability – as predictors of register-based disability pension and long-term sickness absence over a three-year follow-up. Methods: Survey responses of 11,131 Finnish employees were linked to pension and long-term (more than 10 days) sickness absence register data by Statistics Finland. Work ability score was divided into poor (0–5), moderate (6–7) and good/excellent (8–10) and future work ability into poor (1–2) and good (3) work ability at baseline. Cox proportional hazard regressions were used in the analysis of disability pension, and a negative binomial model in the analysis of long-term sickness absence. The results were adjusted for several background, work- and health-related covariates. Results: Compared with those with good/excellent work ability scores, the hazard ratios of disability pension after adjusting for all covariates were 9.84 (95% CI 6.68–14.49) for poor and 2.25 (CI 95% 1.51–3.35) for moderate work ability score. For future work ability, the hazard ratio was 8.19 (95% CI 4.71–14.23) among those with poor future work ability. The incidence rate ratios of accumulated long-term sickness absence days were 3.08 (95% CI 2.19–4.32) and 1.59 (95% CI 1.32–1.92) for poor and moderate work ability scores, and 1.51 (95% CI 0.97–2.36) for poor future work ability. Conclusions: The single items of work ability score and future work ability predicted register-based disability pension equally well, but work ability score was a better predictor of register-based long-term sickness absence days than future work ability in a three-year follow-up. Both items seem to be of use especially when examining the risk of poor work ability for disability but also for long sick leave.

scholarly journals How often do partial disability pensioners end up on a full disability pension?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Polvinen ◽  
M Laaksonen
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Disability Pension ◽  
Mental Health Problems ◽  
Musculoskeletal Diseases ◽  
Disability Retirement ◽  
Working Lives ◽  
Low Education ◽  
History Of

Abstract Background Extending working lives and deferring retirement have been important topics of discussion in recent years. Full disability pensioners seldom work, but most partial disability pensioners continuing working while receiving a pension. However, very little is known about how often partial disability pensioners end up on a full disability pension. The aims of this study were to investigate to what degree partial disability pensions become full disability pensions, and how age, gender, marital status, education, unemployment or a disability diagnosis are associated with that. Methods The register data included 2,969 Finns who were aged 18-59 years and whose partial disability retirement started in 2010. The follow-up period ranged from 2010 to the end of 2015. Cox models were used to estimate hazard ratios for full disability retirement. Results Approximately 40 per cent of the partial disability pensioners ended up on a full disability pension during the follow-up period. Partial disability pensioners who were older, had a lower educational level or a history of unemployment, or who suffered from mental disorders ended up on a full disability pension more often than others. The risk of full disability retirement was 1.5-fold among those with mental disorders compared to those with musculoskeletal diseases. Conclusions Partial disability pensioners with a low education, a history of unemployment or who suffer from mental disorders experience a higher risk of ending up on a full disability pension. More focus should be paid to improving education, preventing mental health problems and unemployment in order to help the disabled work longer. Key messages Preventing partial disability pensioners from ending up on a full disability pension can extend their working lives. Partial disability pensioners with a low education, a history of unemployment or poor mental health more often stop working altogether. More focus should be paid to improving these issues.

scholarly journals Musculoskeletal pain intensity in different body regions and risk of disability pension among female eldercare workers: prospective cohort study with 11-year register follow-up

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rúni Bláfoss ◽  
Jonas Vinstrup ◽  
Sebastian Venge Skovlund ◽  
Rubén López-Bueno ◽  
Joaquin Calatayud ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pain Intensity ◽  
Labour Market ◽  
Musculoskeletal Pain ◽  
Dose Response ◽  
Disability Pension ◽  
Low Back ◽  
Body Regions ◽  
Very High

Abstract Background Musculoskeletal pain is a risk factor for leaving the labour market temporarily and permanently. While the presence of multi-site pain increases the risk of disability pension, we lack detailed knowledge about pain intensity as a risk factor. This study investigated the association between musculoskeletal pain intensity in different body regions and risk of future disability pension among eldercare workers. Methods Eight thousand seven hundred thirty-one female eldercare workers replied to a questionnaire on work and health in 2005 and were followed for 11 years in the Danish Register for Evaluation of Marginalization. Time-to-event analyses estimated hazard ratios (HR) for disability pension from pain intensities (0–9 numeric rating scale (NRS)) in the low-back, neck/shoulders, and knees during the previous 3 months. Analyses were mutually adjusted for pain regions, age, education, lifestyle, psychosocial work factors, and physical exertion at work. Results During 11-year follow-up, 1035 (11.9%) of the eldercare workers received disability pension. For all body regions among all eldercare workers, dose-response associations were observed between higher pain intensity and risk of disability pension (p < 0.001). The risk for disability pension was increased when reporting “very high” pain levels (≥7 points on the 0–9 NRS) in the low-back (HR 2.19, 95% CI 1.70–2.82), neck/shoulders (HR 2.34, 95% CI 1.88–2.92), and knees (HR 1.89, 95% CI 1.44–2.47). Population attributable risks (PAR) were 15.5, 23.2, and 9.6% for pain > 2 on NRS in the low-back, neck/shoulders, and knees, respectively, indicating that 15.5, 23.2, and 9.6% fewer eldercare workers would likely receive disability pension if the pain intensity was reduced to 2 or less. For workers ≤45 years and > 45 years, PAR was highest for neck/shoulder pain (27.6%) and low-back pain (18.8%), respectively. Conclusions The present study found positive dose-response associations between pain intensity in the low-back, neck/shoulders, and knees, and risk of disability pension during 11-year follow-up. Moderate to very high levels of musculoskeletal pain in eldercare workers should, therefore, be considered an early warning sign of involuntary premature exit from the labour market. These findings underscore the importance of preventing, managing, and reducing musculoskeletal pain to ensure a long and healthy working life.

Gender segregation of occupations and sustainable employment: A prospective population-based cohort study

2018 ◽  
Vol 47 (3) ◽  
pp. 348-356 ◽  
Author(s):  
Lena Gonäs ◽  
Anders Wikman ◽  
Marjan Vaez ◽  
Kristina Alexanderson ◽  
Klas Gustafsson
Keyword(s):  
Cohort Study ◽  
Labour Market ◽  
Sickness Absence ◽  
Disability Pension ◽  
Population Based ◽  
Gender Segregation ◽  
Labour Market Situation ◽  
Market Situation ◽  
Male Dominated

Background: Although the labour market is characterized by a strong numerical gender segregation of occupations, there is little knowledge about the associations of this with the future labour market situation for an individual person. Objectives: This study aimed to elucidate whether working in a gender-segregated or gender-integrated occupation is associated with future labour market attachment and sickness absence or disability pensions among women and men. Methods: We used a population-based prospective cohort study with univariate and multiple logistic regression analyses stratified by gender, including all people living in Sweden aged 20–56 years and in paid work in 2003 ( n=3,239,989). They were followed up eight years later with regard to employment status, sickness absence and disability pension. Results: Women and men employed in extremely female-dominated occupations in 2003 had the highest employment levels and the lowest unemployment levels at follow up in 2011. When adjusting for age, level of education and sector of employment, the highest odds ratios (ORs) for not being employed in 2011 were found for women working in extremely male-dominated occupations in 2003 (OR 1.27; 95% CI 1.21–1.33) and for men in female-dominated occupations (OR 1.42; 95% CI 1.39–1.45) relative to those in gender-integrated occupations. Women in extremely male-dominated occupations had the highest ORs for sickness absence or the receipt of a disability pension at follow up (OR 1.26; 95% CI 1.17–1.36) and men in female-dominated occupations had the highest OR 1.15 (95% CI 1.11–1.20). Conclusions: For both women and men, the gender composition of the occupation they work in seems to be of importance for their future labour market attachment and sickness absence or receipt of a disability pension.

scholarly journals Common mental disorders and disability pension award: Seven year follow-up of the HUSK study

2010 ◽  
Vol 69 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Ann Kristin Knudsen ◽  
Simon Øverland ◽  
Helene Flood Aakvaag ◽  
Samuel B. Harvey ◽  
Matthew Hotopf ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Disability Pension ◽  
Common Mental Disorders

Adverse outcomes of sick leave due to mental disorders: A prospective study of discordant twin pairs

2017 ◽  
Vol 47 (2) ◽  
pp. 127-136 ◽  
Author(s):  
Lisa Mather ◽  
Victoria Blom ◽  
Gunnar Bergström ◽  
Pia Svedberg
Keyword(s):  
Mental Disorders ◽  
Sick Leave ◽  
Disability Pension ◽  
Cox Proportional Hazards ◽  
Adverse Outcomes ◽  
Shared Environment ◽  
Hazard Ratios ◽  
Time Varying Covariates ◽  
Discordant Twin

Aims: The aim of this study was to investigate whether sick leave due to different mental disorders increased the risk of reoccurring sick-leave, disability pension and unemployment, taking genetics and shared environment into account. Methods: This register-based cohort study contains 2202 discordant twin pairs 18–64 years old, where one twin had sick leave due to a mental disorder 2005–2006. The end of the sick-leave spell was the start of follow-up for both twins. The twins were followed up for reoccurring sick-leave, disability pension and unemployment (> 180 days in a year), until December 2012. Analyses were censored for disability pension, death, emigration and old-age pension. Cox proportional hazards models with time-varying covariates were used to calculate hazard ratios with 95% confidence intervals (CI). Results: Those with sick leave due to mental disorders had a 3.64 (CI: 3.24–4.08) times higher risk of reoccurring sick-leave within the first two years; after that, hazard ratios were attenuated and explained by genetic factors. The first year, they had 12.24 (CI: 8.11–18.46) times the risk of disability pension. The risk was attenuated but remained at 2.75 (CI: 2.07–3.65) after one year. The risk of unemployment was 1.99 (CI: 1.72–2.31) during the whole follow-up period. The risk of unemployment and disability pension was lower for those with stress-related than other mental disorders, this was less clear for recurrent reoccuring sick-leave. Conclusions: Sick leave due to mental disorders increased the risk of reoccurring sick-leave within two years, disability pension and unemployment, independent of genetics and shared environment.

scholarly journals Associations between combinations of job demands and job control among 6,16,818 people aged 55–64 in paid work with their labour market status 11 years later: a prospective cohort study

2021 ◽  
Author(s):  
Kristin Farrants ◽  
J. Head ◽  
E. Framke ◽  
R. Rugulies ◽  
K. Alexanderson
Keyword(s):  
Labour Market ◽  
Disability Pension ◽  
Social Assistance ◽  
Job Demands ◽  
Job Control ◽  
Paid Work ◽  
Market Status ◽  
High Control ◽  
Labour Market Status

Abstract Background Given current discussions about extending working lives, more knowledge is needed on working conditions associated with labour market status in older age. Objective To explore associations between combinations of job demands and job control among workers aged 55–64 years and their labour market status 11 years later. Methods A population-based prospective cohort study using nationwide register data. The 616,818 individuals in Sweden aged 55–64 who in 2001 were in paid work were categorised using a job exposure matrix based on tertiles (reference = medium control/medium demands). Participants were followed up in 2012 regarding their main labour market status (paid work, old-age pension, no income/social assistance, sickness absence/disability pension, emigrated, dead; reference = old-age pension) using multinomial logistic regression for odds ratios (OR) and 95% confidence intervals (CI). The fully adjusted analyses included adjustment for sociodemographic factors and unemployment or sickness absence/disability pension for more than half the year in 2001. Results Those in occupations with low job control at baseline were less likely to be in paid work at follow-up (OR low demands/low control 0.74, CI 0.71–0.78; high demands/low control 0.81, CI 0.75–0.87). Those in occupations with baseline high demands were less likely to have no income/social assistance at follow-up (OR high demands/low control 0.71, CI 0.52–0.96; high demands/high control 0.59, CI 0.47–0.75). Conclusion Job demands and control when aged 55–64 were associated with labour market status 11 years later: high control was associated with greater chance of being in paid work, and high demands were associated with lower risk of no income/social assistance.

scholarly journals M131. RETURN TO LABOUR MARKET IN SCHIZOPHRENIA AND OTHER PSYCHOSES – THE NORTHERN FINLAND BIRTH COHORT 1966

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S185-S185
Author(s):  
Tuomas Majuri ◽  
Hanna Huovinen ◽  
Tanja Nordström ◽  
Leena Ala-Mursula ◽  
Jouko Miettunen ◽  
...  
Keyword(s):  
General Population ◽  
Psychiatric Disorder ◽  
Return To Work ◽  
Labour Market ◽  
Disability Pension ◽  
Occupational Outcomes ◽  
Occupational Outcome ◽  
Schizophrenia Group

Abstract Background People with psychotic disorders typically have the poorest rate of employment compared to other mental disorders. However, the chances of returning back to labour market and work after long-term work disability is unclear. Aim of this study was to study proportion of persons who can return to labour market after they have received disability pension. We also aim to study potential predictors for return to work. Methods The study was based on the Northern Finland Birth Cohort 1966 (NFBC1966) (N=12 058) which is an unselected, general population-based sample. NFBC1966 offers us a unique way to examine return to labour market and its predictors in general population sample with true prospectively collected data with 50-years follow-up. Different national registers were utilized in the study (information about psychiatric diagnoses and occupational outcomes). Occupational outcomes until end of the 2016 were measured by information about disability pension, disability benefits and employment contracts. The sample included 232 schizophrenia patients, 208 persons with other psychosis and 1927 persons with non-psychotic psychiatric disorder diagnosed until the end of 2016. There is also large amount of predictor data (for occupational outcomes) collected since birth until recent years. Results Of the 141 (61%) persons with schizophrenia who had been on disability pension due to psychiatric reason, disability pensions of 16 (11%) persons had ended due to return to labour market. Of the 74 (32%) persons in the other psychosis subgroup and 180 (9%) in the non-psychotic psychiatric disorder subgroup who had been on disability pension due to psychiatric reason, corresponding numbers of pension’s ending due to return to labour market were 18 (24%) and 56 (31%), respectively. Disability pensions of 14 (10%) persons in schizophrenia group, 3 (4%) persons in other psychosis subgroup and 4 (2%) persons in non-psychotic psychiatric disorder subgroup had ended due to death. Disability pensions of 111 (79%) persons in schizophrenia group, 53 (72%) persons in other psychosis subgroup and 120 (67%) persons in non-psychotic psychiatric disorder subgroup were still running. Later, also sociodemographic information, psychiatric and somatic comorbidity and age at the onset of disease as predictors for the good occupational outcome (i.e. return to work) will be analysed and presented. Discussion Our results indicate that having schizophrenia diagnosis often means relatively poor occupational outcome compared to other psychiatric disorders and ending up on disability pension. Besides of that some people with psychosis manage to maintain their working ability, some people also manage to return to labour market after being on disability pension. Finding the predictors for returning back to labour force in long-time follow-up can help us to cut off the long-term disability periods and support people back to work in the future.

Sign in / Sign up

Export Citation Format

Share Document