Disability pension due to common mental disorders and healthcare use before and after policy changes; a nationwide study

Rahman, Syed; Mittendorfer‐Rutz, Ellenor; Alexanderson, Kristina; Jokinen, Jussi; Tinghög, Petter

doi:10.1093/eurpub/ckw211

Cited by 12 publications

(16 citation statements)

References 32 publications

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“…In general, a strong reduction after granted DP was reported in the outpatient psychiatric healthcare in cohort 2, while it increased in cohort 1. This result was consistent with a previous Swedish study (117). In cohort 1 a possible explanation of the patterns can be a higher level of temporary DP with a lower medical severity in comparison to cohort 2.…”

Section: Study I and Ii: Risk Of Disability Pension In The General Posupporting

confidence: 93%

“…After that there was a period of three months when the individual could not be granted SA-benefits (however, could have other benefits). After July 2008, temporary DP was no longer possible from the age of 30, and specific assessments of claimant's eligibility to SA benefits were established at three, six, and twelve months of a SA spell (115,117). Generally, since the implementation of the 2008 reform, both DP and SA rates have been reduced (118).…”

Section: Changes In Sickness Absence and Disability Pension Rulesmentioning

confidence: 99%

“…The utilization of psychiatric inpatient healthcare declined after DP granting. Possible explanations might be the cessation of work demands, improvements of the symptomatology or a referral of the patient to the primary healthcare (117). Non-Western immigrants showed a stronger decrease.…”

Section: Study I and Ii: Risk Of Disability Pension In The General Pomentioning

confidence: 99%

“…After the introduction of stricter DP granting criteria (2008) the prevalence rates of psychiatric outpatient healthcare were generally higher. Possible explanation can be a higher severity in symptomatology among individuals granting DP after the changes of social insurance system (117,147). In general, a strong reduction after granted DP was reported in the outpatient psychiatric healthcare in cohort 2, while it increased in cohort 1.…”

Section: Study I and Ii: Risk Of Disability Pension In The General Pomentioning

confidence: 99%

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

Thiene

Mittendorfer‐Rutz

Rahman

et al. 2019

European Journal of Public Health

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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.

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Section: Study I and Ii: Risk Of Disability Pension In The General Posupporting

confidence: 93%

Section: Changes In Sickness Absence and Disability Pension Rulesmentioning

confidence: 99%

Section: Study I and Ii: Risk Of Disability Pension In The General Pomentioning

confidence: 99%

Section: Study I and Ii: Risk Of Disability Pension In The General Pomentioning

confidence: 99%

See 2 more Smart Citations

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

Thiene

Mittendorfer‐Rutz

Rahman

et al. 2019

European Journal of Public Health

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show abstract

“…In the following two years, the decline in SA was somewhat faster in our 2010 cohort. This difference might imply an impact of the stricter Swedish SA/DP regulations implemented in 2008 [57,58]. However, the hypothesis should be studied further using other study designs.…”

Section: Strengths and Limitationsmentioning

confidence: 96%

Sickness absence and disability pension among women with breast cancer: a population-based cohort study with a predictive model

Kvillemo

Chen

Bottai

et al. 2019

Preprint

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Women’s return to work after diagnosis of breast cancer (BC) are becoming more prevalent. However, register-based national investigation on sickness absence (SA) and disability pension (DP) in BC women is lacking. The aim of the study was to explore SA and DP before and after a first BC diagnosis and the possibility to predict new cancer-related SA by using disease-related and sociodemographic factors. Methods: A longitudinal register study of the 3536 women in Sweden aged 19-64 with a first BC diagnosis in 2010 was conducted by linkage of multiple national registers. Particularly, information on SA and DP was obtained from the National Social Insurance Agency’s database. Descriptive statistics on SA and DP two years before and three years after the BC diagnosis were performed. The risk of having a new SA spell due to BC or BC-related diagnoses was modeled using logistic regression. Results: The proportion of women with SA increased during the year following the BC diagnosis date and declined over the next two years to proportions before diagnosis. At the time of BC diagnosis, half of the women began a new SA spell >14 days with cancer, cancer-related, or mental diagnosis. Disease-related and sociodemographic factors including occupational sector, living area, age, cancer stage, educational level, and number of previous SA days showed statistical significance (p<0.05) in predicting a new SA around BC diagnosis. By using these factors, it was possible to correctly predict 67% of the new SA spell. Conclusions: SA among women with BC was elevated mainly in the first year after diagnosis. New SA following BC diagnosis can accurately be predicted.

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Socioeconomic inequalities in treatment of individuals with common mental disorders regarding subsequent development of mental illness

Dörner

Mittendorfer‐Rutz

2017

Soc Psychiatry Psychiatr Epidemiol

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PurposeSocioeconomic differences appear to be reflected in both, the development and the treatment of common mental disorders (CMDs, i.e. depressive, anxiety and stress-related disorders). Underlying mechanisms of these inequalities are to date not fully understood. This study aimed to investigate if (1) there are socioeconomic differences with regard to type of treatment and (2) if the socioeconomic status modifies the association between treatment and subsequent inpatient care or suicide attempt, respectively, in individuals with CMDs.MethodsThe study population comprised 66,097 individuals aged 18–59 on sick-leave due to a CMD during 2006 in Sweden. Cox regression with a follow-up from 2007 through 2010 estimated crude and multivariate hazard ratios (HR) with 95% confidence intervals (CI).ResultsIndividuals with sickness absence due to CMDs and a higher educational level were had a lower proportions of specialised health care and combined psychiatric medication than their counterparts with lower education. However, if high educated CMD patients received more combined medication, associations with subsequent mental inpatient care (p < 0.01) and suicide attempt (p < 0.05) were stronger than for their counterparts with low education. Moreover, previous inpatient care due to mental disorders was associated with higher HRs of subsequent suicide attempt in CMD patients with high education (HR 5.88; CI 3.02–11.45) compared to those with low education (1.96; 1.06–3.60).ConclusionFindings suggest that socioeconomic inequalities shape differences in treatment measures and mental health development in individuals with CMDs. These differences might signal discrepancies in treatment per se or reflect morbidity differences requiring different treatment regimens, or may be due to the fact that different diagnoses are given in different educational strata due to differential role of stigma.

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Disability pension due to common mental disorders and healthcare use before and after policy changes; a nationwide study

Cited by 12 publications

References 32 publications

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

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

Sickness absence and disability pension among women with breast cancer: a population-based cohort study with a predictive model

Socioeconomic inequalities in treatment of individuals with common mental disorders regarding subsequent development of mental illness

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