scholarly journals Mental health in childhood and adolescence in association to sickness absence and disability pension

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Narusyte ◽  
R Amin ◽  
A Ropponen ◽  
P Svedberg

Abstract Background A large amount of studies have previously reported associations between sociodemographic, socioeconomic, health- and work-related factors and future sickness absence (SA) or disability pension (DP). However, the knowledge is still scarce regarding the associations between mental health problems and disorders during childhood and adolescence in association to future work incapacity, and regarding the role of familial influences on the associations. Methods The studies were based on 2,690 twins born 1985-1986 in Sweden who participated in the Twin Study of CHild and Adolescent Development (TCHAD). The twins were followed repeatedly at ages of 8-9, 13-14, 16-17, and 19-20 years. The presence of depressive, anxiety, rule-breaking, and social phobia symptoms were assessed through self-reports. SA and DP data were obtained from national registries. Group-based trajectory, logistic regression and Cox proportional regression analyses were applied. Results More than half of the twins that were on SA or granted DP had stable moderate levels of the mental health symptoms during adolescence. Cox regression analyses showed that rule-breaking behavior was associated with a higher risk for SA with the highest HR of 1.12 (95% CI 1.05-1.19) at age of 8-9 years. High levels of anxious and depressive symptoms were associated with DP despite age at symptom assessment. The associations attenuated slightly when familial factors were taken into account. The association between social phobia and SA was to some extent explained by sex and parental education except for when social phobia was measured at ages 19-20 years (OR 1.22, 95% CI 1.10-1.34). The results changed slightly when further adjusting for familial factors. Conclusions Familial factors had no major importance for the studied associations. Hence, early life public health interventions to improve mental health might reduce the risk of future work incapacity in young adulthood.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Chen ◽  
K Alexanderson

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.


2017 ◽  
Vol 46 (3) ◽  
pp. 321-330 ◽  
Author(s):  
Ulla Kinnunen ◽  
Jouko Nätti

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.


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.


2019 ◽  
Vol 29 (5) ◽  
pp. 931-936
Author(s):  
Ridwanul Amin ◽  
Pia Svedberg ◽  
Jurgita Narusyte

Abstract Background Little is known about adolescent mental health problems, including social phobia, as risk factors for future work incapacity. The aim of this study was to investigate the association between social phobia in adolescence and unemployment and sickness absence (SA) in early adulthood, also evaluating the role of familial factors (genetics and shared environment). Methods A sample of 2845 Swedish twins born in 1985–86 in Sweden was followed longitudinally in the population-based and prospective Twin study of CHild and Adolescent Development. Information on twins’ social phobia was collected at ages 13–4, 16–7 and 19–20 years. Logistic regression providing odds ratios (OR) with 95% confidence intervals (95% CI) was used to analyze the associations between social phobia, unemployment and SA during the follow-up 2006–12. The influence of familial factors was evaluated by conditional logistic regression. Results Presence of social phobia during adolescence was associated with increased odds for unemployment and SA in young adulthood. For unemployment, the highest OR was at the age of 13–4 years (1.58 [95% CI: 1.22–2.06]), and the associations became null after adjusting for familial factors. For SA, the highest OR was at the age of 19–20 years (1.73 [95% CI: 1.13–2.65]), and the estimates changed slightly after adjusting for familial factors. Conclusions : Results suggest that social phobia experienced in adolescence contribute to early adulthood unemployment and SA. Familial factors seemed to explain the association between social phobia and unemployment.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Narusyte ◽  
P Svedberg

Abstract Background Mental health problems among young adults is a public health problem as well as increasing work incapacity in terms of sickness absence (SA) due to mental diagnoses in Sweden. SA levels among those working in the public sector tend to exceed those working in the private sector. Knowledge is however lacking on whether experiencing mental health problems in young years can contribute to the association. The aim was to examine the association between type of employment and sickness absence among women and men, also adjusting for previously experienced depression and anxiety as well as for familial factors. Methods The study included data on 25,496 twins born in Sweden 1959-1990. Information on depression and anxiety as well as on type of employment was obtained from a web-based survey conducted in 2005. Twins were followed prospectively until 2013 through national register data on SA. Logistic regression analyses were run with adjustment for familial factors, such as common genetics and environmental factors related to the family. Odds ratios (OR) with 95% Confidence Intervals (CI) are presented. Results Higher rates of SA in the public (59%) as compared to the private (50%) sector were observed among women. There were 29% and 30% of men in public and private sectors, respectively, that have had at least one SA spell during the follow-up. Preliminary results showed that working in the private sector was associated with a higher risk for future SA among women (OR 1.63, 95% CI 1.14-2.33) but not among men (OR 0.66, 95% CI 0.41-1.07). The results changed only slightly after adjusting for previous depression or anxiety as well as for familial factors. Conclusions Higher rates of SA among women working in the public as compared to the private sector were not explained by previously experienced depression or anxiety disorders. Key messages Higher rates of SA were observed among women working in public as compared to private sector. Previously experienced depression and anxiety were of similar importance for future SA in both public and private sectors.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sandra Blomqvist ◽  
Hugo Westerlund ◽  
Kristina Alexanderson ◽  
Linda L. Magnusson Hanson

Abstract Background A maintained psychological wellbeing is important in order to continue working longer and remain active into older age. However, little is known about impact of different organizational factors, such as downsizing, on the mental health of older workers exiting the labor market. The aim in this study was to investigate trajectories of purchases of psychotropic drugs in relation to labor market exit later in life in a context with and without downsizing. Method People living in Sweden, born 1941–1951, exiting paid work via unemployment, sickness absence/disability pension, or old-age pension were followed from 2005 to 2013 regarding purchases of psychotropic drugs. Individuals employed at a workplace closing down or downsizing with ≥18% between two subsequent years were compared to employees exiting from workplaces without downsizing or workplace closure. Generalized estimating equations was applied to derive trajectories of annual prevalence of purchased antidepressants, sedatives and anxiolytics from 4 years before to 4 years after a labour market exit. Results During the period around the exit, old-age retirees experiencing a downsizing/workplace closure did not decrease their purchases of sedatives (OR 1.01 95% CI 0.95–1.07) while the unexposed decreased their purchases during this period (OR 0.95 95% CI 0.92–0.98). Similar differences concerning sedatives and antidepressants between exposed and unexposed were seen for those exiting via sickness absence or disability pension. Furthermore, a significant difference in purchases of anxiolytics was observed between those exposed to downsizing (OR 1.10 95% CI 0.97–1.24) and the unexposed (OR 0.98 95% CI 0.91–1.06) exiting via old-age retirement during the time before the exit. Conclusion Downsizing or workplace closure, although weakly, was associated with higher prevalence of psychotropic drugs certain years around the labor market exit. The results support the idea that involuntary labor market exit in mature adulthood may negatively affect the development of mental health.


2013 ◽  
Vol 24 (1) ◽  
pp. 106-110 ◽  
Author(s):  
J. Narusyte ◽  
A. Ropponen ◽  
K. Alexanderson ◽  
P. Svedberg

2020 ◽  
Author(s):  
Lydia Gabriela Speyer ◽  
Anastasia Ushakova ◽  
Hildigunnur Anna Hall ◽  
Michelle Luciano ◽  
Bonnie Auyeung ◽  
...  

Background: Most mental health difficulties have their onset during childhood and adolescence. Many children who suffer from one mental health issue also suffer from at least one comorbid disorder. Autoregressive latent trajectory models with structured residuals (ALT-SR) and multilevel graphical vector autoregression (GVAR) are recent complementary approaches that can help provide new insights into the reciprocal relationships between multiple mental health domains and advance the understanding of the development of comorbidities.Methods: This study uses ALT-SR and multilevel GVAR models to analyse the temporal, contemporaneous and between-person relationships between emotional problems, peer problems, conduct problems, hyperactivity/inattention and prosociality as measured by the parent-reported Strengths and Difficulties Questionnaire (SDQ) in 17,478 children taking part in the UK Millennium Cohort Study at ages 3, 5, 7, 11, 14 and 17 years. Results: Results from both the ALT-SR model and the multilevel GVAR model highlight that children’s strengths and difficulties in different domains of psychosocial functioning dynamically influence each other over- and within-time. The ALT-SR model highlighted that hyperactivity/inattention plays a central role in affecting other domains over developmental time while the GVAR model highlighted comparably strong bidirectional relationships between conduct problems and prosociality as well as between emotional problems and peer problems. Both models suggest that most domains are also related to each other over shorter timescales.Conclusion: This study highlights that mental health difficulties influence one another dynamically over time. As illustrated in the domains of the SDQ, these dynamic changes can be modelled using the complementary techniques of ALT-SR or GVAR models, each offering different insights into the nature of comorbidity.


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