Overland Simon, Glozier Nicholas, Sivertsen Børge, Stewart Robert, Neckelmann Dag, Krokstad Steinar, Mykletun Amnstein
Research Centre for Health Promotion, University of Bergen, Bergen, Norway.
Sleep. 2008 Jun;31(6):875-80. doi: 10.1093/sleep/31.6.875.
Depression and insomnia are common and frequently comorbid. Unlike the priority now accorded to depression, insomnia is comparatively ignored as a reason for impaired occupational functioning. The objective of this study was to compare their relative impact upon medically certified disability pension award.
Historical cohort study
Data from a population-based health survey in Nord-Trøndelag County in Norway (HUNT-2) was linked with a comprehensive national social security database.
Participants within working age (20-66 years of age) not claiming disability pension (N = 37,302).
N/A.
We compared complaints of insomnia and depression as predictors of disability pension award 18-48 months after a health survey. Insomnia complaints and depression each were similarly associated with disability pension award after adjustment for multiple health and sociodemographic factors, with similar odds ratios (1.66 [1.37-2.01] and 1.56 [1.24-1.96] respectively). Comorbidity did not contribute to disability beyond that expected from each condition. Taking the higher prevalence of insomnia complaints into account, insomnia complaints contributed as much or even more than depression to work-related disability.
Depression is regarded as a major contributor to work disability and is increasingly the primary diagnosis in disability pension award. Our results suggest that although rarely reported in official registries of disability pension causes, insomnia has an equally important and independent role, particularly among the younger group. This suggests that this potentially treatable factor has considerable economic impact and should receive more attention in clinical and public health management.
抑郁症和失眠症很常见，且经常同时出现。与目前对抑郁症的重视程度不同，失眠症作为职业功能受损的一个原因相对被忽视。本研究的目的是比较它们对医学认证的残疾抚恤金授予的相对影响。
历史性队列研究
来自挪威北特伦德拉格郡一项基于人群的健康调查（HUNT-2）的数据与一个全面的国家社会保障数据库相链接。
年龄在工作年龄段（20 - 66岁）且未申请残疾抚恤金的参与者（N = 37302）。
无。
我们比较了失眠症和抑郁症的主诉，以此作为健康调查后18 - 48个月残疾抚恤金授予的预测因素。在对多种健康和社会人口学因素进行调整后，失眠症主诉和抑郁症与残疾抚恤金授予的关联相似，优势比分别为1.66（1.37 - 2.01）和1.56（1.24 - 1.96）。共病对残疾的影响并不超过每种疾病单独预期的影响。考虑到失眠症主诉的患病率较高，失眠症主诉对与工作相关的残疾的影响与抑郁症相当甚至更大。
抑郁症被视为工作残疾的主要原因，并且在残疾抚恤金授予中越来越成为主要诊断。我们的结果表明，尽管在残疾抚恤金原因的官方登记中很少报告，但失眠症具有同样重要且独立的作用，尤其是在较年轻的群体中。这表明这个潜在可治疗的因素具有相当大的经济影响，在临床和公共卫生管理中应受到更多关注。
