Sick leave due to mental disorders, morbidity and mortality: a prospective study of discordant twin pairs

Abstract

Purpose To investigate if sick leave due to mental disorders increases the risk of morbidity measured by inpatient and specialized outpatient care, and mortality among women and men, independent of familial factors. Methods An open cohort study of 4979 twin pairs discordant for sick leave due to mental disorders was conducted in 2005-2013. Twins were followed up in the cause of death and national patient registries until the end of study, emigration, death, and inpatient and specialized outpatient care. Conditional Cox proportional hazard regression, adjusting for the familial factors shared by the twins, was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). In case of non-proportional hazards, time-varying covariates were used. Results Sick leave due to mental disorders increased the risk for inpatient care among men (

Role of social benefits for future long-term sickness absence, disability pension and unemployment among individuals on sickness absence due to mental diagnoses: a competing risk approach

“…Furthermore, we had a large working age population-based sample which enabled us to identify almost 4000 first incident SA spells due to mental diagnoses to be followed for labor market outcomes. A limitation of this study is that we had only register data and therefore lacked access to many social, health related or lifestyle factors affecting employment o sustainable working life (Dorner et al 2015;Mather et al 2020;Mather et al 2019a;Mather et al 2019b). The utilization of register data, although from multiple sources, do not completely rule out common method bias (Podsakoff et al 2012) which may have inflated our results, but one can assume that the direction of associations would be retained.…”

“…Until now, relatively few studies have investigated consequences of SA due to mental diagnoses in terms of unemployment or DP (Norder et al 2017;Ubalde-Lopez et al 2017). Although a recent interest has been in studies of young adults (Di Thiene et al 2019;Helgesson et al 2018) and discordant twin pairs (Mather et al 2019a) to identify factors predicting labor market outcomes among those with mental health problems, most studies have focused on adverse outcomes of SA in general (Bryngelson et al 2013;Dorner et al 2015;Gjesdal et al 2009;Gjesdal et al 2008). Another aspect meriting further studies is the competing risks approach-i.e.…”

The role of sickness absence diagnosis for the risk of future inpatient- or specialized outpatient care in a Swedish population-based twin sample

“…Our results based on the comparison of the whole cohort to discordant twin pairs showed the point estimates to retain the magnitude and direction, suggesting there is weak or no effect of familial confounding in the associations between SA due to various diagnosis groups and patient care. Hence this independency from familial confounding suggest direct link between SA and patient care although we expected to see familial confounding based on the genetic influence on many chronic diseases that leads to SA [25][26][27][28], but also on SA itself [9,22]. For (occupational) health care including any preventive actions for SA and/or hospitalizations in terms of inpatient-or specialized outpatient care means both tailored interventions specified by the underlying condition or diagnosis as well as monitoring SA.…”

“…On the other hand, besides SA, also patient care in terms of inpatientor specialized outpatient care, is often needed for various symptoms and diseases [20,21]. Some studies have addressed SA as a predictor of patient care [15,22] although usually the pathway has been estimated utilizing the initiation from care, i.e. from onset of a disease, symptom or medication that required medical attention in a care unit, to SA [23,24].…”

“…blood pressure [28]. Since genetics is also known to affect SA [9,22], there is a need for studies accounting for familial factors (genetics and mainly childhood environment) in associations of SA and potential consequences. A twin study with a co-twin control design utilizing twin pairs discordant for a factor of interest provides possibility to define if an association between SA and inpatient care is influenced by familial factors [29,30].…”