Work Organizations, Finnish Institute of Occupational Health, Helsinki, Finland.
J Affect Disord. 2011 Nov;134(1-3):365-72. doi: 10.1016/j.jad.2011.05.028. Epub 2011 Jun 12.
Work disability due to common mental disorders has increased in Western countries during the past decade. The contribution of depressive, anxiety, and alcohol use disorders to all disability pensions at the population level is not known.
Epidemiological health data from the Finnish Health 2000 Study, gathered in 2000-2001, was linked to the national register on disability pensions granted due to the ICD-10 diagnoses up to December 2007. Mental health at baseline was assessed using the Composite International Diagnostic Interview (CIDI). Sociodemographic, clinical, and work-related factors, health behaviors, and treatment setting were used as covariates in the logistic regression analyses among the 3164 participants aged 30-58 years.
Anxiety, depressive, and comorbid common mental disorders predicted disability pension when adjusted for sex and age. In the fully adjusted multivariate model, comorbid common mental disorders, as well as physical illnesses, age over 45 years, short education, high job strain, and previous long-term sickness absence predicted disability pension.
The study population included persons aged 30 or over. Sub groups according to mental disorders were quite small which may have diminished statistical power in some sub groups. Baseline predictors were measured only once and the length of exposure could not be determined. The systems regarding financial compensation to employees differ between countries.
Comorbid mental disorders pose a high risk for disability pension. Other independent predictors of work disability include socio-demographic, clinical, work-related, and treatment factors, but not health behavior. More attention should be paid to work-related factors in order to prevent chronic work disability.
在过去十年中，由于常见精神障碍导致的工作残疾在西方国家有所增加。但在人群水平上，抑郁、焦虑和酒精使用障碍对所有残疾抚恤金的贡献尚不清楚。
使用 2000-2001 年收集的芬兰健康 2000 研究的流行病学健康数据，并与截至 2007 年 12 月因 ICD-10 诊断而获得的国家残疾抚恤金登记处相联系。使用复合国际诊断访谈 (CIDI) 在基线评估心理健康。在 3164 名 30-58 岁的参与者中，使用社会人口统计学、临床和与工作相关的因素、健康行为和治疗环境作为逻辑回归分析的协变量。
焦虑、抑郁和共病常见精神障碍在调整性别和年龄后预测残疾抚恤金。在完全调整的多变量模型中，共病常见精神障碍以及身体疾病、45 岁以上、受教育程度低、高工作压力和以前长期病假与残疾抚恤金相关。
研究人群包括 30 岁或以上的人。根据精神障碍分组的人数相当少，这可能会降低某些亚组的统计效力。基线预测因子仅测量一次，无法确定暴露时间的长短。各国的员工经济补偿制度不同。
共病精神障碍对残疾抚恤金构成高风险。工作残疾的其他独立预测因素包括社会人口统计学、临床、与工作相关和治疗因素，但不包括健康行为。应更加关注工作相关因素，以预防慢性工作残疾。
