Risk Factors for Suicidal Behaviour in Individuals on Disability Pension Due to Common Mental Disorders - A Nationwide Register-Based Prospective Cohort Study in Sweden

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

doi:10.1371/journal.pone.0098497

Cited by 17 publications

(17 citation statements)

References 46 publications

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“…As a limitation, potential unmeasured residual confounding can be mentioned. By using information from in- and specialized outpatient care, only morbidity of greater medical severity was captured [ 47 ]. Also, the validity of DP diagnoses must be discussed, although it has not been studied.…”

Section: Discussionmentioning

confidence: 99%

Risk of disability pension in first and second generation immigrants: the role of age and region of birth in a prospective population-based study from Sweden

Thiene¹,

Helgesson²,

Alexanderson³

et al. 2017

BMC Public Health

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BackgroundIn several countries, immigrants have higher disability pension (DP) rates than natives. Reasons for this are poorly understood. The aim of this study was to investigate if the risk of diagnosis-specific DP differed in first, second, and second/intermediate generation immigrants compared to natives, in general and across regions of birth, and stratified by age.MethodsA population-based prospective cohort study of all 3,507,055 individuals aged 19–50 years and living in Sweden in 2004 with a 6-year follow-up period. Hazard ratios (HR) and 95% confidence intervals (CI) for mental and somatic DP were estimated by Cox regression for first, second, and second/intermediate generation immigrants compared to natives, across regions of birth and stratified by age.ResultsAfter multivariate adjustment, HRs for both mental and somatic DP were higher at follow-up in the first generation compared to natives: mental HR 1.17 (CI 1.12–1.22) and somatic 1.15 (1.09–1.22) for individuals <35 years; 1.74 (1.69–1.79) and 1.70 (1.66–1.74) ≥35 years (median), respectively. Immigrants born in Europe outside EU25, and countries outside Europe had particularly elevated HRs. Also in the second generation, HRs were higher in mental 1.29 (1.21–1.37) and somatic DP: 1.30 (1.19–1.42) in those <35 years; and 1.18 (1.10–1.27); and 1.10 (1.03–1.17) for those ≥35 years, respectively. Among second generation immigrants there were no strong differences in HRs between regions of birth.ConclusionsCompared to natives, the risk of DP was higher in first and second generation immigrants. Higher estimates were seen for immigrants from Europe outside EU25 and from the rest of the world in the first generation. No considerable differences in estimates regarding mental or somatic DP diagnoses were found.

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Section: Discussionmentioning

confidence: 99%

Risk of disability pension in first and second generation immigrants: the role of age and region of birth in a prospective population-based study from Sweden

Thiene¹,

Helgesson²,

Alexanderson³

et al. 2017

BMC Public Health

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“…While several other variables have been usually related with poor outcomes (such as unemployment, being unmarried and public insurance) 10,21 , no other studies have evaluated transient disability, a very common condition in inpatients in Brazil; our results show increased OR for transient disability in relation to employed/active status on the groups with intermediate (OR vary from 3.96 to 4.36) and poor (OR vary from 9.43 to 15.01) outcomes. Disability pension due to mental disorders has been associated with increased suicide risk 25 and heavy use of psychiatric inpatients services 26 , while this outcomes have not yet been evaluated in transient disability. On the other hand, being employed/active in occupational status was associated with a good outcome, which has been extensively replicated in the literature 10,15 .…”

Section: Discussionmentioning

confidence: 99%

Factors related to positive and negative outcomes in psychiatric inpatients in a General Hospital Psychiatric Unit: a proposal for an outcomes index

Moreschi¹,

Pavan²,

Godoy³

et al. 2015

Arch. Clin. Psychiatry

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Background: General Hospital Psychiatric Units have a fundamental importance in the mental health care systems. However, there is a lack of studies regarding the level of improvement of patients in this type of facility. Objective: To assess factors related to good and poor outcomes in psychiatric inpatients using an index composed by clinical parameters easily measured. Methods: Length of stay (LOS), Global Assessment of Functioning (variation and at discharge) and Clinical Global Impression (severity and improvement) were used to build a ten-point improvement index (I-Index). Records of psychiatric inpatients of a general hospital during an 18-month period were analyzed. Three groups (poor, intermediate and good outcomes) were compared by univariate and multivariate models according to clinical and sociodemographic variables. Results: Two hundred and fifty patients were included, with a percentage in the groups with poor, regular and good outcomes of 16.4%, 59,6% and 24.0% respectively. Poor outcome at the discharge was associated mainly with lower education, transient disability, antipsychotics use, chief complaint "behavioral change/aggressiveness" and psychotic features. Multivariate analysis found a higher OR for diagnoses of "psychotic disorders" and "personality disorders" and others variables in relation to protective categories in the poor outcome group compared to the good outcome group. Discussion: Our I-Index proved to be an indicator of that allows an easy and more comprehensive evaluation to assess outcomes of inpatients than just LOS. Different interventions addressed to conditions such as psychotic disorders and disruptive chief complaints are necessary.

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“…Moreover, there is well-documented knowledge regarding sex differences regarding both SA/DP and suicidal behaviour [18,19]. Generally, women are reported to have higher levels of SA/DP [4,18] and are more likely to attempt suicide [1] than men, whereas suicide is more common among men [19]. However, sex differences in the association between SA/DP due to CMDs and suicidal behaviour remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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

Wang

Mather

Svedberg

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

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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.

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Risk Factors for Suicidal Behaviour in Individuals on Disability Pension Due to Common Mental Disorders - A Nationwide Register-Based Prospective Cohort Study in Sweden

Cited by 17 publications

References 46 publications

Risk of disability pension in first and second generation immigrants: the role of age and region of birth in a prospective population-based study from Sweden

Risk of disability pension in first and second generation immigrants: the role of age and region of birth in a prospective population-based study from Sweden

Factors related to positive and negative outcomes in psychiatric inpatients in a General Hospital Psychiatric Unit: a proposal for an outcomes index

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

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