Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzeliusväg 3, 171 77, Stockholm, Sweden.
Soc Psychiatry Psychiatr Epidemiol. 2012 Dec;47(12):1999-2009. doi: 10.1007/s00127-012-0498-5. Epub 2012 Mar 20.
The incidence of disability pension (DP), especially due to mental diagnoses, has increased in many countries, but knowledge of socio-demographic risk factors for DP is limited. Further, the influences of genetics and early-life factors (jointly called familial factors) on these associations remain to be studied. The aims were to study incidence of DP (due to all and mental diagnoses) and associations with socio-demographic factors, and also to establish whether associations differ with DP diagnosis and sex, and are influenced by familial factors.
A prospective cohort study of all twins born in 1928-1958 (n = 52,609) in Sweden was conducted. The twins were followed from 1993 to 2008 regarding DP. Cox proportional hazard models were applied.
The cumulative incidence of DP was 17 %. Of all the DP diagnoses 20 % were mental. Higher age (≥45 years), being a woman or unmarried, and/or living in a semi-urban area were risk factors for DP. Low education, being a blue-collar worker or being self-employed predicted either higher (all diagnoses) or lower (mental diagnoses) risk of DP. Rural areas were associated with DP due to mental diagnoses. The estimates varied for men and women. After adjustment for familial factors the associations of DP with education and marital status were attenuated and no longer significant. Similar results were apparent for DP due to mental diagnoses and socioeconomic status.
Familial factors may select individuals into some of the established risk environments for DP. Studies investigating the causes of DP need to take such confounding into account.
在许多国家，残疾抚恤金（DP）的发生率，特别是由于精神诊断导致的 DP 发生率有所增加，但对导致 DP 的社会人口学风险因素知之甚少。此外，遗传和早期生活因素（统称为家族因素）对这些关联的影响仍有待研究。本研究旨在探讨 DP（包括所有和精神诊断）的发生率及其与社会人口学因素的关联，并确定这些关联是否因 DP 诊断和性别而不同，以及是否受家族因素影响。
对瑞典所有 1928-1958 年出生的双胞胎（n=52609）进行前瞻性队列研究。从 1993 年到 2008 年，对双胞胎的 DP 情况进行了随访。采用 Cox 比例风险模型进行分析。
DP 的累积发生率为 17%。所有 DP 诊断中，20%为精神疾病。年龄较大（≥45 岁）、女性或未婚，以及/或居住在半城市地区是 DP 的风险因素。低教育程度、蓝领工人或个体经营者预测 DP 的风险更高（所有诊断）或更低（精神诊断）。农村地区与精神疾病导致的 DP 有关。这些估计值因男性和女性而异。调整家族因素后，DP 与教育程度和婚姻状况的关联减弱，不再具有统计学意义。精神疾病导致的 DP 与社会经济地位也出现了类似的结果。
家族因素可能会使个体处于 DP 的某些既定风险环境中。研究 DP 病因的研究需要考虑到这种混杂因素。
