Karpansalo M, Kauhanen J, Lakka T A, Manninen P, Kaplan G A, Salonen J T
Department of Public Health and General Practice, University of Kuopio, PO Box 1927, 70120 Kuopio, Finland.
J Epidemiol Community Health. 2005 Jan;59(1):70-4. doi: 10.1136/jech.2003.010702.
Mental depression is an important health problem in many countries. It reduces productivity at work and is the fastest increasing reason for early retirement.
This study followed up a Finnish cohort of 1726 men from 1984 to 2000. Depression was assessed at baseline by HPL depression score. Pension records were obtained from the national pension registers. Cox's regression analysis was used to estimate the associations of depression with the risk of all disability pensions combined, separately for different causes of disability, and non-illness based pension.
During the follow up, 839 men (48.6%) received a disability pension. A total of 142 men (16.9% of all disability pensions) retired because of mental disorder and of these, 75 (52.8%) because of depression. After adjustment for the potential confounders, men in the highest third of depression score had an increased risk of non-illness based pension (RR 1.86 95% CI 1.37 to 2.51) and disability pension attributable to mental disorders (RR 2.74, 95% CI 1.68 to 4.46), chronic somatic diseases (RR 1.68, 95% CI 1.05 to 2.71), cardiovascular diseases (RR 1.61, 95% CI 1.12 to 2.32). The mean age of retirement for men with a high and low depression score was 57.6 years (SD 3.87) and 59.1 years (SD 3.65) (p<0.001) respectively.
A high depression score predicted disability attributable to any cause, especially mental disorders, and non-illness based pensions. Depressed people retired on average 1.5 years younger than those without depression. Further studies are needed to elucidate the pathways of how mental depression leads people to seek retirement pension.
精神抑郁在许多国家都是一个重要的健康问题。它会降低工作效率,并且是提前退休人数增长最快的原因。
本研究对1984年至2000年期间芬兰的1726名男性队列进行了随访。在基线时通过HPL抑郁评分评估抑郁情况。从国家养老金登记处获取养老金记录。使用Cox回归分析来估计抑郁与所有残疾养老金综合风险之间的关联,分别针对不同的残疾原因以及非因病退休的养老金情况。
在随访期间,839名男性(48.6%)领取了残疾养老金。共有142名男性(占所有残疾养老金的16.9%)因精神障碍退休,其中75名(52.8%)因抑郁退休。在对潜在混杂因素进行调整后,抑郁评分处于最高三分位的男性领取非因病退休养老金的风险增加(风险比1.86,95%置信区间1.37至2.51),因精神障碍领取残疾养老金的风险增加(风险比2.74,95%置信区间1.68至4.46),因慢性躯体疾病领取残疾养老金的风险增加(风险比1.68,95%置信区间1.05至2.71),因心血管疾病领取残疾养老金的风险增加(风险比1.61,95%置信区间1.12至2.32)。抑郁评分高和低的男性的平均退休年龄分别为57.6岁(标准差3.87)和59.1岁(标准差3.65)(p<0.001)。
高抑郁评分预示着因任何原因导致的残疾,尤其是精神障碍,以及非因病退休的养老金情况。抑郁者平均比无抑郁者提前1.5年退休。需要进一步研究以阐明精神抑郁导致人们寻求退休养老金的途径。