Population Research Unit, Department of Social Research, University of Helsinki, PO Box 59, 00014, Helsinki, Finland,
Soc Psychiatry Psychiatr Epidemiol. 2014 Apr;49(4):639-49. doi: 10.1007/s00127-013-0747-2. Epub 2013 Aug 8.
Mental disorders are the key causes of disability retirement and are associated with a high risk of mortality. Social variations in excess mortality after disability retirement are nevertheless poorly understood. We examined socio-demographic differences in all-cause and cause-specific mortality after disability retirement due to depression and other mental disorders.
The data comprised a nationally representative sample of the Finnish population aged 25-64 in 1996 with no prior disability retirement due to mental disorders (N = 392,985). We used Cox regression analysis with disability retirement due to mental disorders as a time-varying covariate and mortality between 1997 and 2007 as the outcome variable.
We found excess mortality after disability retirement due to mental disorders as compared to those with no such retirement in all specific causes of death, in particular alcohol-related causes, suicide, and other unnatural causes. Excess suicide mortality was particularly large after depression-based disability retirement. Younger age groups, non-manual classes, and those living with a partner and children had largest excess mortality, especially from unnatural and alcohol-related causes. However, the absolute number of excess deaths was not always largest in these socio-demographic groups.
In young adulthood, disability retirement due to depression signifies severe health and other social disadvantages that lead to particularly large excess mortality, especially due to unnatural causes. The protective effects of a high socioeconomic position and family ties against unnatural and alcohol-related deaths are limited among those who have already developed depression or other mental disorders that have led to disability retirement.
精神障碍是残疾退休的主要原因，并与高死亡率相关。然而，残疾退休后过度死亡的社会差异仍未得到充分理解。我们研究了因抑郁和其他精神障碍而残疾退休后的全因和特定原因死亡率的社会人口学差异。
该数据包括 1996 年芬兰年龄在 25-64 岁之间、之前没有因精神障碍而残疾退休的人群的全国代表性样本（N=392985）。我们使用 Cox 回归分析，将因精神障碍而残疾退休作为时变协变量，将 1997 年至 2007 年期间的死亡率作为结果变量。
与没有残疾退休的人群相比，我们发现因精神障碍而残疾退休后存在所有特定死因的过度死亡率，特别是与酒精相关的死因、自杀和其他非自然原因。基于抑郁的残疾退休后自杀死亡率特别高。年龄较小的群体、非体力劳动阶层、与伴侣和孩子同住的人，以及非自然和酒精相关原因的死亡率过高。然而，这些社会人口学群体并不总是死亡人数最多。
在青年时期，因抑郁而残疾退休意味着严重的健康和其他社会劣势，导致过度死亡率特别高，尤其是非自然原因导致的死亡。高社会经济地位和家庭关系对非自然和酒精相关死亡的保护作用在已经患有抑郁或其他导致残疾退休的精神障碍的人群中是有限的。
