scholarly journals Trajectories of sickness absence, disability pension and unemployment in young immigrants with common mental disorders

2019 ◽  
Vol 29 (6) ◽  
pp. 1055-1062 ◽  
Author(s):  
D Di Thiene ◽  
E Mittendorfer-Rutz ◽  
S Rahman ◽  
M Wang ◽  
K Alexanderson ◽  
...  
Keyword(s):  
Sickness Absence ◽  
Educational Level ◽  
Disability Pension ◽  
Psychiatric Comorbidity ◽  
Common Mental Disorders ◽  
Multinomial Logistic Regression ◽  
Common Mental Disorder ◽  
Duration Of Residence ◽  
Before And After ◽  
Young Immigrants

Abstract Background The aims were to elucidate if trajectories of labour market marginalization (LMM), measured as sickness absence (SA)/disability pension (DP) or unemployment, differed between young immigrants and natives before and after an incident diagnosis of a common mental disorder (CMD), and to investigate if educational level, psychiatric comorbidity and duration of residence in Sweden (in immigrants) had different associations with subsequent LMM in natives compared with immigrants. Methods A total of 28 971 young adults (19–30 years), with an incident CMD (inpatient or specialized outpatient healthcare due to CMDs or dispensed prescribed antidepressants during 2007) were included. Group-based trajectory models were utilized to identify trajectories of annual months of LMM 3 years before and 6 years after the diagnosis. The associations of risk factors with different trajectories were investigated by multinomial logistic regression, χ2-test and Nagelkerke R2 to measure the associations’ strength. Immigrants were categorized into Western and non-Western immigrants. Results Young natives and immigrants showed similar trajectories of SA/DP. A higher proportion of non-Western immigrants (20.5%) followed trajectories of high levels of unemployment (>2 annual months) compared with Western immigrants (15%) and natives (16.5%). Educational level and duration of residence in Sweden (in immigrants) discriminated trajectories of both SA/DP and unemployment, whereas psychiatric comorbidity only discriminated trajectories of SA/DP. Conclusions Differences in trajectories of unemployment between young natives and immigrants with an incident CMD were found. Educational level and psychiatric comorbidity provided information on differences between natives and immigrants and duration of residence gave information for subgroups of immigrants.

scholarly journals Work disability before and after incident myocardial infarction and subsequent common mental disorder

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Bokenberger ◽  
S Rahman ◽  
M Wang ◽  
M Vaez ◽  
T E Dorner ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Sickness Absence ◽  
Work Disability ◽  
Disability Pension ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Cox Models ◽  
Hazard Ratios ◽  
Antidepressant Prescription ◽  
Before And After

Abstract Background This study investigated the extent to which work-disability patterns including sickness absence and disability pension (SA/DP) before and after acute myocardial infarction (AMI) were associated with subsequent common mental disorders (CMDs) such as depression and anxiety in AMI patients without previous CMD. Methods A cohort of 11,493 patients aged 26-64 years without previous CMD with incident AMI during 2008-2010 were followed up for CMD measured as antidepressant prescription through 2013. Four SA/DP trajectory groups during the 3 years pre-AMI and 1 year post-AMI were identified. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated in Cox models. Results Higher pre-AMI SA/DP levels (>1-12 months/year), compared to the majority of patients (78%) following low increasing annual levels (increasing up to 1 month/year) of pre-AMI SA/DP, were associated with a 40-60% increased CMD rate. Regarding post-AMI findings, constant high (∼25-30 days/month) and steeply decreasing SA/DP levels within the first 3 months were associated with a 76% and 35% higher CMD rate, respectively, compared to constant low (<1 days/month) levels. Conversely, a gradually decreasing pattern of post-AMI SA/DP over a 12-month period suggested protective influences for CMD (HR = 0.80), even after adjusting for sociodemographic and medical factors. Conclusions This is the first study to demonstrate that pre- and post-AMI work disability patterns are associated with subsequent CMD risk in AMI patients. Work disability patterns should be considered in clinical practice as an indicator of AMI prognosis in terms of CMD risk. Key messages Increasing and high persistent levels of pre-AMI work disability are associated with higher risk of subsequent CMD, while gradually decreasing post-AMI work disability has a favourable CMD prognosis. Pre- and post-AMI patterns of work disability (sickness absence and disability pension) can be a useful marker in terms of CMD prognosis.

scholarly journals Trajectories of antidepressant use and characteristics associated with trajectory groups among young refugees and their Swedish-born peers with diagnosed common mental disorders—findings from the REMAIN study

2021 ◽  
Author(s):  
S. Rahman ◽  
S. Filatova ◽  
L. Chen ◽  
E. Björkenstam ◽  
H. Taipale ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Disability Pension ◽  
Common Mental Disorders ◽  
Multinomial Logistic Regression ◽  
Common Mental Disorder ◽  
Influential Factors ◽  
Transcultural Psychiatry ◽  
Refugee Youth ◽  
Study Population ◽  
Antidepressant Use

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.

scholarly journals Sickness absence and disability pension sequences before and after a bicycle crash; a Swedish study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Kjeldgård ◽  
H Stigson ◽  
K Alexanderson ◽  
E Friberg
Keyword(s):  
Sickness Absence ◽  
Disability Pension ◽  
Brain Injuries ◽  
Multinomial Logistic Regression ◽  
Body Region ◽  
Full Time ◽  
Direct Connection ◽  
Before And After ◽  
Part Time ◽  
Type Of Injury

Abstract Background In recent years, bicycle injuries have increased, yet little is known about impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore the long-term patterns of SA and DP among injured bicyclists. Methods A longitudinal register-based study was conducted, including all individuals aged 18-59 years and living in Sweden, who in 2010 had incident in- or specialized out-patient healthcare for injuries sustained in a bicycle crash. Information about sociodemographics, the injury, SA, DP, and deaths were obtained from several nationwide registers. Weekly SA/DP data for four years: one year before and three years after the crash were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each sequence cluster. Results Among all 6465 individuals injured in a bicycle crash 2010, five clusters were identified: No SA or DP (60.2%), Immediate SA (17.7%), Episodic SA (15.3%), Part-time DP (1.6%), and Full-time DP (5.2%). Compared to the cluster No SA or DP, all other clusters had high ORs for female sex, older age, living in small cities/villages, and inpatient care. Immediate SA also had high ORs for cyclists who sustained a fracture (OR 5.53; CI 4.47-6.83), dislocation (3.26; 2.29-4.65), sprains and strains (2.29; 1.68-3.10), and internal injuries (4.39; 1.95-9.90). Episodic SA had high ORs for other traumatic brain injury than concussion (6.27; 2.23-17.64) and injuries located in the spine and back (3.52; 2.12-5.86), torso (1.78; 1.29-2.45), upper extremities (1.95; 1.54-2.46), and lower extremities (1.85; 1.43-2.41). Conclusions Having SA in direct connection to the crash was associated with type of injury, in contrast to Episodic SA where the injured body region was of more importance, in particular other traumatic brain injuries and injuries to the spine and back. Key messages This nationwide study of new bicycle crashes found five clusters of sickness absence (SA) and disability pension (DP) sequences; No SA or DP, Immediate SA, Episodic SA, Part-time DP, and Full-time DP. The type of injury was more important for SA in direct connection to the crash, while the injured body region was of more importance for continued and repeated SA up to three years after the crash.

scholarly journals Trajectories of sickness absence and disability pension in colorectal cancer: a Swedish cohort study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Chen ◽  
K Alexanderson
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Sickness Absence ◽  
Educational Level ◽  
Disability Pension ◽  
Population Based ◽  
Work Situation ◽  
Working Age ◽  
Future Work ◽  
Very High

Abstract Background Working-aged colorectal cancer (CRC) patients have a much better survival nowadays, indicating the importance of their future work situation. We aimed to investigate trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis and in references, and risk factors associated with different trajectories. Methods A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19-62 when first diagnosed with CRC in 2008-2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi2 test and multinomial logistic regression. Results Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all, n = 2481), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level (R2=0.022), Charlson's Comorbidity Index (R2=0.029), and prediagnostic mental disorders (R2=0.066) were the strongest factors determining the SADP trajectory groups. In references, three trajectories (”constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified. Conclusions Approximately 80% of CRC survivors return to a low level of SADP (0-60 days/year) at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for CRC survivors. Key messages Most of working-age colorectal cancer survivors have low levels of sickness absence and disability pension days five years after their diagnosis. Trajectory analyses based on population-based register data can be used as a good approach in understanding future work situation regarding sick leave among working-age cancer survivors.

scholarly journals Suicide attempt following sickness absence and disability pension due to common mental disorders: a prospective Swedish twin study

2019 ◽  
Vol 55 (8) ◽  
pp. 1053-1060 ◽  
Author(s):  
M. Wang ◽  
L. Mather ◽  
P. Svedberg ◽  
E. Mittendorfer-Rutz
Keyword(s):  
Mental Disorders ◽  
Suicide Attempt ◽  
Sickness Absence ◽  
Disability Pension ◽  
Depressive Disorders ◽  
Proportional Hazards ◽  
Common Mental Disorders ◽  
Cox Proportional Hazards ◽  
Shared Environment ◽  
Familial Factors

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.

scholarly journals Sickness absence and disability pension in relation to first childbirth: three cohorts in Sweden

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Bjorkenstam ◽  
C Orellana ◽  
K Laszlo ◽  
P Svedberg ◽  
M Voss ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Sickness Absence ◽  
Young Women ◽  
Disability Pension ◽  
Age Groups ◽  
Population Based ◽  
Multiple Births ◽  
First Birth ◽  
Period Effects ◽  
Before And After

Abstract Background Childbirth is suggested to be associated with elevated levels of sickness absence (SA) and disability pension (DP). However, knowledge about patterns of SA/DP before and after childbirth as compared to patterns among women who remain nulliparous is limited. We aimed to compare SA/DP across several periods among women with different childbirth status. Methods We analysed three population-based cohorts of all women aged 18-39 years who had not previously given birth and who lived in Sweden on 31 December 1994, 1999, or 2004, respectively. We compared crude and standardized annual mean SA and DP net days during three years preceding to three years after the date of first childbirth, among women having (1) their first and only birth during the subsequent three years, (2) their first birth and at least another delivery, and (3) no childbirths before, nor during the study period. Results Despite an increase in SA in the year preceding the first childbirth, women who gave birth, and especially women with multiple births, tended to have lower levels of SA/DP days throughout the years than women without childbirths. SA/DP days varied across age groups; young women (aged 18-24 years) without childbirths had fewer SA days, but more DP days than their same-aged counterparts who gave birth, regardless of year. These results did not differ across the three cohorts, suggesting that the results were not affected by period effects. Conclusions Women with more than one childbirth had fewer days of SA and DP, as compared to women with one childbirth and to women having no births. Thus, childbirth does not seem to be associated with higher levels of SA and DP. Some of these results can be due to a health selection into giving birth, especially having more births. Key messages Except for the year before delivery, i.e., when pregnant, women giving birth had fewer SA and DP days than women with no births. Thus, childbirth does not seem to be associated with higher SA and DP. Women who had more than one childbirth had less SA/DP days than those with one childbirth.

Mortality in persons with disability pension due to common mental disorders: A cohort study of Swedish construction workers

2019 ◽  
Vol 48 (8) ◽  
pp. 832-838
Author(s):  
Mia Söderberg ◽  
Linus Schiöler ◽  
Mikael Stattin ◽  
Alex Burdorf ◽  
Bengt Järvholm
Keyword(s):  
Relative Risk ◽  
Confidence Interval ◽  
Mental Disorder ◽  
Psychiatric Diagnosis ◽  
Disability Pension ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Construction Workers ◽  
Relative Risks

Aims: This study investigated mortality in disability pensions due to common mental disorder, and variation over time after first receiving disability pension. Methods: Objectives were explored in 301,863 construction workers (97.2% men) recruited through healthcare examinations from 1971–1993. By linking with the Swedish National Insurance Agency registers, disability pensions until 2014 were identified. Common mental disorder was defined as disability pension diagnosis due to anxiety, stress-related disorders or moderate depression. Mortality was calculated in all-psychiatric diagnosis and diagnostic sub-groups, and compared to persons without disability pensions, using Poisson regression. Additional analyses were stratified by age at follow-up. Results: In total 6030 subjects received disability pensions based on psychiatric diagnoses, and 2624 constituted common mental disorder. Analyses in an all-psychiatric diagnosis displayed increased mortality risks in men (relative risk 3.6; 95% confidence interval 3.3–3.9) and women (relative risk 2.1; 95% confidence interval 1.6–2.6). Common mental disorder was associated with mortality, especially in men (relative risk 2.5; 95% confidence interval 2.2–2.8). Increased relative risks in alcohol and substance abuse were also observed. Results in analyses stratified by age at follow-up displayed persistent high relative risks for mortality in older ages (75–89 years) in men in all-psychiatric disability pensions diagnosis (relative risk 2.8; 95% confidence interval 2.1–3.7) and common mental disorder diagnosis (relative risk 2.6; 95% confidence interval 1.8–3.6), compared to men without disability pensions. Similar results were found in women, but few cases lowered the precision of estimates. Conclusions: This study shows that disability pension based on common mental disorders, often regarded as a ‘lighter’ psychiatric diagnosis, is a risk for early mortality in construction workers, even several years after first receiving disability pension.

scholarly journals Sick leave and disability pension before and after breast cancer diagnosis: a Swedish cohort study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L C Chen ◽  
K A Alexanderson
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cohort Study ◽  
Sickness Absence ◽  
Disability Pension ◽  
Breast Cancer Survivors ◽  
Work Capacity ◽  
Cancer Stage ◽  
Breast Cancer Patients ◽  
Before And After

Abstract Background Most working-aged women are, after diagnosed with breast cancer (BC), on some sickness absence and/or disability pension (SADP). We aimed to explore possible trajectories of their previous and subsequent SADP days and risk factors for consistently high levels of future SADP. Methods In a longitudinal cohort study of all 3536 women in Sweden aged 19-64 with a first BC diagnosis in 2010, we calculated their annual SADP net days from two years before to three years after BC diagnosis date. A group-based trajectory model was applied to depict SADP patterns. Logistic regressions were used to calculate odds ratios (OR) with 95% confidence intervals (CI) for having &gt;90 or &gt; 180 SADP days/year in the three postdiagnostic years. Results Three trajectories of SADP days/month over the five years were identified: “high” (30% of all)”, “increase only around diagnosis” (61%), and ’constant very high’ (9%). Across the study period, the risk factors associated with constantly high levels of SADP days (&gt;90 or &gt; 180 days/year) were similar. Particularly, factors significantly associated with having annual SADP &gt;90 days during all the three postdiagnostic years were: stage II cancer (OR = 4.59; 95% CI 2.98-7.07), stage III+IV (OR = 26.57; 13.52-52.22), prediagnosis SA 1-30 days (OR = 2.73; 1.30-5.70), prediagnosis SA &gt; 90 days (OR = 24.52; 12.25-49.08), and prediagnosis DP (OR = 659.97; 292.52-&gt;999.99). Conclusions When diagnosed with BC, SADP increased significantly postdiagnosis, however, decreased with time and the absolute majority had no SADP the third year after BC diagnosis. Advanced cancer stage and previous high SADP were the highest risk factors for later SADP. Key messages Most breast cancer survivors’ work capacity (sickness absence (SA) and disability pension (DP) is only affected shortly post-diagnosis. Prior SADP and high cancer stage were strongest risk factors. Register-based information on breast cancer patients and their sickness absence and disability pension before and after diagnosis are useful to identify different types of return-to-work patterns.

scholarly journals Sickness absence and disability pension before and after first childbirth and in nulliparous women: longitudinal analyses of three cohorts in Sweden

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031593 ◽  
Author(s):  
Charlotte Björkenstam ◽  
Cecilia Orellana ◽  
Krisztina D László ◽  
Pia Svedberg ◽  
Margaretha Voss ◽  
...  
Keyword(s):  
Sickness Absence ◽  
Disability Pension ◽  
Population Based ◽  
Secondary Outcome ◽  
Detailed Knowledge ◽  
Longitudinal Analyses ◽  
Nulliparous Women ◽  
Before And After ◽  
The Mean

ObjectiveChildbirth is suggested to be associated with elevated levels of sickness absence (SA) and disability pension (DP). However, detailed knowledge about SA/DP patterns around childbirth is lacking. We aimed to compare SA/DP across different time periods among women according to their childbirth status.DesignRegister-based longitudinal cohort study.SettingSweden.ParticipantsThree population-based cohorts of nulliparous women aged 18–39 years, living in Sweden 31 December 1994, 1999 or 2004 (nearly 500 000/cohort).Primary and secondary outcome measuresSum of SA >14 and DP net days/year.MethodsWe compared crude and standardised mean SA and DP days/year during the 3 years preceding and the 3 years after first childbirth date (Y−3to Y+3), among women having (1) their first and only birth during the subsequent 3 years (B1), (2) their first birth and at least another delivery (B1+), and (3) no childbirths during follow-up (B0).ResultsDespite an increase in SA in the year preceding the first childbirth, women in the B1 group, and especially in B1+, tended to have fewer SA/DP days throughout the years than women in the B0 group. For cohort 2005, the mean SA/DP days/year (95% CIs) in the B0, B1 and B1+ groups were for Y−3: 25.3 (24.9–25.7), 14.5 (13.6–15.5) and 8.5 (7.9–9.2); Y−2: 27.5 (27.1–27.9), 16.6 (15.5–17.6) and 9.6 (8.9–10.4); Y−1: 29.2 (28.8–29.6), 31.4 (30.2–32.6) and 22.0 (21.2–22.9); Y+1: 30.2 (29.8–30.7), 11.2 (10.4–12.1) and 5.5 (5.0–6.1); Y+2: 31.7 (31.3–32.1), 15.3 (14.2–16.3) and 10.9 (10.3–11.6); Y+3: 32.3 (31.9–32.7), 18.1 (17.0–19.3) and 12.4 (11.7–13.0), respectively. These patterns were the same in all three cohorts.ConclusionsWomen with more than one childbirth had fewer SA/DP days/year compared with women with one childbirth or with no births. Women who did not give birth had markedly more DP days than those giving birth, suggesting a health selection into childbirth.

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