Unit of Expertise in Work and Organizations, Finnish Institute of Occupational Health, Helsinki, Finland.
Occup Environ Med. 2011 Nov;68(11):791-8. doi: 10.1136/oem.2010.061101. Epub 2011 Mar 19.
To examine the associations between socio-economic position (SEP) and the onset of psychiatric work disability, return to work and recurrence of disability.
Prospective observational cohort study (1997-2005) including register data on 141 917 public-sector employees in Finland. Information on International Classification of Diseases, 10th Revision diagnosis-specific psychiatric work disability (≥90 days) was obtained from national registers.
During a mean follow-up of 6.3 years, 3938 (2.8%) participants experienced long-term psychiatric work disability. Of these, 2418 (61%) returned to work, and a further 743 (31%) experienced a recurrent episode. SEP was inversely associated with onset of disability owing to depressive disorders, anxiety disorders, personality disorders, schizophrenia and substance-use disorders. No association was found between SEP and disability owing to bipolar disorders or reaction to severe stress and adjustment disorders. High SEP was associated with a greater likelihood of a return to work following depressive disorders, personality disorders, schizophrenia and substance-use disorders, but not bipolar disorders, anxiety disorders or reaction to severe stress and adjustment disorders. Low SEP predicted recurrent episodes of work disability.
High SEP is associated with lower onset of work disability owing to mental disorders, as well as return to work and lower rates of recurrence. However, the socio-economic advantage is diagnosis-specific. SEP predicted neither the onset and recovery from disability owing to bipolar disorders and reaction to severe stress and adjustment disorders, nor recovery from disability owing to anxiety disorders. SEP should be taken into account in the attempts to reduce long-term work disability owing to mental disorders.
探讨社会经济地位（SEP）与精神障碍所致工作残疾起始、重返工作岗位和残疾复发之间的关系。
这是一项前瞻性观察性队列研究（1997-2005 年），纳入了芬兰 141917 名公共部门雇员的登记数据。从国家登记处获得了国际疾病分类，第 10 版特定精神障碍工作残疾（≥90 天）的诊断信息。
在平均 6.3 年的随访期间，3938 名（2.8%）参与者经历了长期精神障碍工作残疾。其中，2418 名（61%）重返工作岗位，另有 743 名（31%）经历了残疾复发。由于抑郁障碍、焦虑障碍、人格障碍、精神分裂症和物质使用障碍，SEP 与残疾起始呈负相关。SEP 与双相情感障碍或严重应激和适应障碍所致残疾无关。高 SEP 与抑郁障碍、人格障碍、精神分裂症和物质使用障碍后重返工作岗位的可能性更大相关，但与双相情感障碍、焦虑障碍或严重应激和适应障碍后残疾无关。低 SEP 预测工作残疾的复发。
高 SEP 与精神障碍所致工作残疾起始率较低、重返工作岗位和复发率较低有关。然而，社会经济优势是特定于诊断的。SEP 既不能预测双相情感障碍和严重应激及适应障碍所致残疾的起始和恢复，也不能预测焦虑障碍所致残疾的恢复。在努力减少精神障碍导致的长期工作残疾时，应考虑 SEP。
