scholarly journals Disability pension due to common mental disorders and subsequent suicidal behaviour: a Swedish study

2017 ◽  
Vol 27 (suppl_3) ◽  
Author(s):  
SG Rahman ◽  
K Alexanderson ◽  
J Jokinen ◽  
E Mittendorfer-Rutz
2019 ◽  
Vol 55 (8) ◽  
pp. 1053-1060 ◽  
Author(s):  
M. Wang ◽  
L. Mather ◽  
P. Svedberg ◽  
E. Mittendorfer-Rutz

Abstract Purpose The aim of this study was to investigate if sickness absence and disability pension (SA/DP) in general and due to specific common mental disorders (CMDs) are associated with subsequent suicide attempt among women and men by taking familial factors (genetics and shared environment) into consideration. Methods This register-based cohort study includes 4871 twin pairs 18–65 years of age discordant for SA/DP due to CMDs 2005–2010. Twins were followed up for suicide attempt from inpatient and specialised outpatient care until December 2012. Conditional Cox proportional hazards regression models, adjusting for familial factors, were used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results SA/DP due to CMDs was associated with a higher risk of suicide attempt (HR 3.14, CI 2.51–3.93). The risk of suicide attempt was five times higher among men and three times higher among women, compared to the SA/DP unaffected co-twins. In the diagnosis-specific analysis, SA/DP due to anxiety disorders resulted in the highest HR (4.09, CI 2.37–7.06) for suicide attempt, followed by depressive disorders (HR 3.70, CI 2.66–5.14) and stress-related disorders (HR 1.96, CI 1.35–2.84). The stratified analysis on zygosity indicates that there seems to be a genetic influence on the associations between SA/DP due to CMDs and suicide attempt, particularly among women and among those with SA/DP due to depressive disorders. Conclusions SA/DP due to CMDs was a risk factor for suicide attempt among women and men. Genetic factors might explain part of the associations for women and for those with SA/DP due to depressive disorders.


2011 ◽  
Vol 199 (6) ◽  
pp. 459-466 ◽  
Author(s):  
Vikram Patel ◽  
Helen A. Weiss ◽  
Neerja Chowdhary ◽  
Smita Naik ◽  
Sulochana Pednekar ◽  
...  

BackgroundDepressive and anxiety disorders (common mental disorders) are the most common psychiatric condition encountered in primary healthcare.AimsTo test the effectiveness of an intervention led by lay health counsellors in primary care settings (the MANAS intervention) to improve the outcomes of people with common mental disorders.MethodTwenty-four primary care facilities (12 public, 12 private) in Goa (India) were randomised to provide either collaborative stepped care or enhanced usual care to adults who screened positive for common mental disorders. Participants were assessed at 2, 6 and 12 months for presence of ICD-10 common mental disorders, the severity of symptoms of depression and anxiety, suicidal behaviour and disability levels. All analyses were intention to treat and carried out separately for private and public facilities and adjusted for the design. The trial has been registered with clinicaltrials.gov (NCT00446407).ResultsA total of 2796 participants were recruited. In public facilities, the intervention was consistently associated with strong beneficial effects over the 12 months on all outcomes. There was a 30% decrease in the prevalence of common mental disorders among those with baseline ICD-10 diagnoses (risk ratio (RR) = 0.70, 95% CI 0.53–0.92); and a similar effect among the subgroup of participants with depression (RR = 0.76, 95% CI 0.59–0.98). Suicide attempts/plans showed a 36% reduction over 12 months (RR = 0.64, 95% CI 0.42–0.98) among baseline ICD-10 cases. Strong effects were observed on days out of work and psychological morbidity, and modest effects on overall disability. In contrast, there was little evidence of impact of the intervention on any outcome among participants attending private facilities.ConclusionsTrained lay counsellors working within a collaborative-care model can reduce prevalence of common mental disorders, suicidal behaviour, psychological morbidity and disability days among those attending public primary care facilities.


Author(s):  
S. Rahman ◽  
S. Filatova ◽  
L. Chen ◽  
E. Björkenstam ◽  
H. Taipale ◽  
...  

Abstract Purpose This study aimed to (1) identify the trajectories of prescribed antidepressants in refugee youth and matched Swedish-born peers diagnosed with common mental disorder (CMD) and (2) characterize the trajectories according to sociodemographic and medical factors. Methods The study population comprised 2,198 refugees and 12,199 Swedish-born individuals with both Swedish-born parents, aged 16–25 years in 2011, residing in Sweden and treated in specialised healthcare for CMD 2009–11. Group-based trajectory modelling was used to identify different trajectory groups of antidepressant use-based on annual defined daily dosages (DDDs). Multinomial logistic regression was applied to investigate the association of sociodemographic and medical characteristics with the identified trajectories. Nagelkerke pseudo-R2 values were estimated to evaluate the strength of these associations. Results Four trajectory groups of antidepressant use among young refugees were identified with following proportions and DDD levels in 2011: ‘low constant’ (88%, < 100), ‘low increasing’ (2%, ≈710), ‘medium decreasing’ (8%, ≈170) and ‘high increasing’ (2%, ≈860). Similar trajectories, however, with different proportions were identified in Swedish-born: 67%, 7%, 21% and 5%, respectively. The most influential factors discriminating the trajectory groups among refugees were ‘duration of stay in Sweden’ (R2 = 0.013), comorbid ‘other mental disorders’ (R2 = 0.009) and ‘disability pension’ (R2 = 0.007), while ‘disability pension’ (R2 = 0.017), comorbid ‘other mental disorders’ (R2 = 0.008) and ‘educational level’ (R2 = 0.008) were the most important determinants discriminating trajectory groups among Swedish-born youth. Conclusion The lower use of antidepressants in refugees with CMDs compared to their Swedish-born counterparts warrants health literacy programs for refugees and training in transcultural psychiatry for healthcare professionals.


2006 ◽  
Vol 163 (8) ◽  
pp. 1412-1418 ◽  
Author(s):  
Arnstein Mykletun ◽  
Simon Overland ◽  
Alv A. Dahl ◽  
Steinar Krokstad ◽  
Ottar Bjerkeset ◽  
...  

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

2015 ◽  
Vol 46 (2) ◽  
pp. 425-436 ◽  
Author(s):  
T. E. Dorner ◽  
K. Alexanderson ◽  
P. Svedberg ◽  
P. Tinghög ◽  
A. Ropponen ◽  
...  

BackgroundThe aim of this study was to analyse a possible synergistic effect between back pain and common mental disorders (CMDs) in relation to future disability pension (DP).MethodAll 4 823 069 individuals aged 16–64 years, living in Sweden in December 2004, not pensioned in 2005 and without ongoing sickness absence at the turn of 2004/2005 formed the cohort of this register-based study. Hazard ratios (HRs) and 95% confidence intervals (CIs) for DP (2006–2010) were estimated. Exposure variables were back pain (M54) (sickness absence or inpatient or specialized outpatient care in 2005) and CMD (F40-F48) [sickness absence or inpatient or specialized outpatient care or antidepressants (N06a) in 2005].ResultsHRs for DP were 4.03 (95% CI 3.87–4.21) and 3.86 (95% CI 3.68–4.04) in women and men with back pain. HRs for DP in women and men with CMD were 4.98 (95% CI 4.88–5.08) and 6.05 (95% CI 5.90–6.21). In women and men with both conditions, HRs for DP were 15.62 (95% CI 14.40–16.94) and 19.84 (95% CI 17.94–21.94). In women, synergy index, relative excess risk due to interaction, and attributable proportion were 1.24 (95% CI 1.13–1.36), 0.18 (95% CI 0.11–0.25), and 2.08 (95% CI 1.09–3.06). The corresponding figures for men were 1.45 (95% CI 1.29–1.62), 0.29 (95% CI 0.22–0.36), and 4.21 (95% CI 2.71–5.70).ConclusionsCo-morbidity of back pain and CMD is associated with a higher risk of DP than either individual condition, when added up, which has possible clinical implications to prevent further disability and exclusion from the labour market.


Sign in / Sign up

Export Citation Format

Share Document