Diagnosis-specific sick leave as a risk marker for disability pension in a Swedish population

Abstract

Objective: To investigate diagnosis-specific sick leave as a risk marker for subsequent disability pension. Design: A prospective population based cohort study. Exposure to a new medically certified sick leave episode of more than seven days by diagnosis during 1985 was examined in relation to incident causespecific disability pension through 1996. Participants: The total non-retired population of one Swedish county aged 16 to 49 years, alive and not in receipt of a disability pension at the end of 1985 (176 629 persons; 51% men). Main results: To eliminate confounding by sick leaves that translate into a disability pension, the follow up period for disability pension was started five years after the assessment of sick leave. After adjustment for demographic characteristics, the risk of disability pension from mental disorders was 14.1 times higher (95% confidence interval (CI), 12.1 to 16.4) for those with sick leave for mental disorders than for those with no sick leave. The corresponding hazard ratio for sick leave and disability pension within diagnostic category was 5.7 (95% CI, 5.3 to 6.2) for musculoskeletal diseases and 13.0 (7.7 to 21.8) for gastrointestinal diseases. Irrespective of diagnoses, the hazard ratio for sick leave and disability pension was 3.0 (2.9 to 3.1). Conclusions: Sick leave may provide an important risk marker for identifying groups at high risk of a disability pension, especially for psychiatric diagnoses.

Sick leaves in four factories—do characteristics of employees and work conditions explain differences in sickness absence between workplaces?

“…It indicates, by definition, temporary work disability due to the illness of an employee. In addition to temporary illness, chronic diseases and poor perceived health are reflected in higher absence rates (1)(2)(3)(4), and high long-term absence predicts permanent work disability and death (5)(6)(7). Earlier studies also show that past absence is an independent predictor of future absence (8).…”

Obesity status and risk of disability pension due to psychiatric disorders

“…However, Månsson et al also studied middle-aged men, but used a reference group similar to ours (not including underweight), which may explain why the results were consistent with our findings but not with those of Rissanen et al 13 The association of obesity status at age 17-20 years with later DP due to psychiatric disorders other than nonaffective disorders (including schizophrenia) may partially be mediated by psychosocial stress due to negative attitudes toward individuals deviating from the predominant norms and BMI, psychiatric disorders and disability pension M Kark et al values in society about body size and shape. 11,[18][19][20] The less acceptable it is to be underweight, overweight or obese in a society or group, the stronger the psychological pressure may become. The perception of being too heavy according to prevailing body appearance norms may create considerable psychosocial stress and lower self-esteem, and unsuccessful attempts to lose weight may worsen the situation.…”

Employees Sick-Listed with Mental Disorders: Who Returns to Work and When?

“…Employed people with mental disorders lose three times more work days in a 12-months' period compared to people without mental disorders [2]. Furthermore, mental disorders are associated with an increased risk of disability pensioning [5][6][7][8][9]. The Organization for Economic Co-operation and Development reported that mental disorders account for up to one-third of disability pension awards in western European countries [10].…”