Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland.
Eur J Epidemiol. 2013 May;28(5):417-26. doi: 10.1007/s10654-013-9792-0. Epub 2013 Mar 19.
The association between retirement and mental health is assumed to depend on socio-demographic factors, but there is a lack of empirical evidence. We examined antidepressant medication before and after retirement by age, gender, living arrangements, and social class. The material comprised nationally representative register data from Finland. Linear regression analysis was used to calculate changes in antidepressant medication 7.5 years before and after disability (N = 42,937) and old-age (N = 19,877) retirement in 1997-2007 by socio-demographic factors. No changes in antidepressant medication (mean DDD/3-month period) were observed around old-age retirement regardless of the socio-demographic factors. After a slight initial increase in antidepressant medication there was a substantial rise 1.5-0 years before disability retirement, after which there was a marked decrease, particularly during the first 3 years. These effects were less pronounced in retirement due to somatic causes. Age was the strongest modifying factor in retirement due to both depression and somatic causes, with a stronger increase and limited decrease in antidepressant medication among the younger age groups. The post-retirement decrease was also somewhat stronger among men, and among those in higher social classes and those living with a spouse in depression-related retirement. In somatic causes, the pre-retirement increase was stronger among those in higher social classes. Prevention and rehabilitation of mental-health problems in association with work disability should focus particularly on young adults, among whom the strong increase in antidepressant medication before disability retirement, and the continued high levels of medication after the transition signify long periods of morbidity and premature retirement.
退休与心理健康之间的关系假定取决于社会人口因素，但缺乏经验证据。我们根据年龄、性别、居住安排和社会阶层，检查了退休前后的抗抑郁药物使用情况。该材料包括来自芬兰的全国代表性登记数据。线性回归分析用于计算 1997-2007 年残疾（N=42937）和老年（N=19877）退休前 7.5 年和后抗抑郁药物（按 3 个月时间段计算的 DDD）的社会人口因素变化。无论社会人口因素如何，老年退休前后抗抑郁药物（按 3 个月时间段计算的 DDD）均无变化。在最初略有增加后，在残疾退休前 1.5-0 年有显著上升，之后显著下降，尤其是在前 3 年。这些影响在因躯体原因退休时不太明显。年龄是因抑郁和躯体原因退休的最强调节因素，在年轻人群组中，抗抑郁药物的增加幅度更大，下降幅度有限。在退休后，男性、社会阶层较高和与配偶一起生活的人群中，抗抑郁药物的下降幅度也稍大。在躯体原因中，社会阶层较高的人群在退休前的增加幅度更大。应特别关注与工作残疾相关的心理健康问题的预防和康复，尤其是在残疾退休前抗抑郁药物大量增加的年轻人中，以及过渡后持续高水平药物治疗的人群中，这表明他们存在较长时期的发病和过早退休。
