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Excess mortality after disability retirement due to mental disorders: variations by socio-demographic factors and causes of death.

Abstract：

PURPOSE:Mental disorders are the key causes of disability retirement and are associated with a high risk of mortality. Social variations in excess mortality after disability retirement are nevertheless poorly understood. We examined socio-demographic differences in all-cause and cause-specific mortality after disability retirement due to depression and other mental disorders. METHODS:The data comprised a nationally representative sample of the Finnish population aged 25-64 in 1996 with no prior disability retirement due to mental disorders (N = 392,985). We used Cox regression analysis with disability retirement due to mental disorders as a time-varying covariate and mortality between 1997 and 2007 as the outcome variable. RESULTS:We found excess mortality after disability retirement due to mental disorders as compared to those with no such retirement in all specific causes of death, in particular alcohol-related causes, suicide, and other unnatural causes. Excess suicide mortality was particularly large after depression-based disability retirement. Younger age groups, non-manual classes, and those living with a partner and children had largest excess mortality, especially from unnatural and alcohol-related causes. However, the absolute number of excess deaths was not always largest in these socio-demographic groups. CONCLUSIONS:In young adulthood, disability retirement due to depression signifies severe health and other social disadvantages that lead to particularly large excess mortality, especially due to unnatural causes. The protective effects of a high socioeconomic position and family ties against unnatural and alcohol-related deaths are limited among those who have already developed depression or other mental disorders that have led to disability retirement.

journal_name

Soc Psychiatry Psychiatr Epidemiol

journal_title

Social psychiatry and psychiatric epidemiology

authors

Leinonen T,Martikainen P,Laaksonen M,Lahelma E

doi

10.1007/s00127-013-0747-2

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

639-49

issue

eissn

0933-7954

issn

1433-9285

journal_volume

pub_type

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Excess mortality after disability retirement due to mental disorders: variations by socio-demographic factors and causes of death.