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常见精神障碍与特定病因的病退

Common mental disorders and cause-specific disability retirement.

作者信息

Lahelma E, Pietiläinen O, Rahkonen O, Lallukka T

机构信息

Department of Public Health, University of Helsinki, Helsinki, Finland.

Department of Public Health, University of Helsinki, Helsinki, Finland Finnish Institute of Occupational Health, Helsinki, Finland.

出版信息

Occup Environ Med. 2015 Mar;72(3):181-7. doi: 10.1136/oemed-2014-102432. Epub 2014 Nov 14.

Abstract

OBJECTIVES

Common mental disorders are prevalent among employees and may cause work disability. We aimed to examine the association between common mental disorders and disability retirement, with an emphasis on the severity of disorders and diagnostic causes for retirement.

METHODS

Our data were derived from the Helsinki Health Study cohort on the staff of the City of Helsinki, Finland. The baseline mail surveys were made in 2000-2002 among employees reaching ages 40, 45, 50, 55 and 60 in each year (n=8960, response rate 67%, 80% women). Disability retirement events from national registers (n=628) were followed up by the end of 2010 and linked to the baseline data. After exclusions, the number of participants was 6525. Common mental disorders were measured by the General Health Questionnaire 12-item version (GHQ-12). Covariates at baseline included sociodemographic, work-related and health-related factors. Hazard ratios (HR) and 95% CIs were calculated using Cox proportional hazards models.

RESULTS

Common mental disorders showed a graded association with disability retirement. For disability retirement due to any diagnostic cause, the fully adjusted HR for the GHQ-12 score 7-12 was 2.16, 95% CI 1.63 to 2.85. For disability retirement due to mental disorders the corresponding HR was 7.46, 95% CI 4.46 to 12.49. For disability retirement due to musculoskeletal diseases, the association was weaker and did not survive all adjustments.

CONCLUSIONS

Common mental disorders are an important antecedent of disability retirement in general and due to mental disorders in particular. Successful measures against common mental disorders may prevent disability retirement due to mental disorders.

摘要

目的

常见精神障碍在员工中普遍存在,可能导致工作残疾。我们旨在研究常见精神障碍与残疾退休之间的关联,重点关注障碍的严重程度和退休的诊断原因。

方法

我们的数据来自芬兰赫尔辛基市员工的赫尔辛基健康研究队列。2000 - 2002年对每年满40、45、50、55和60岁的员工进行了基线邮件调查(n = 8960,回复率67%,女性占80%)。到2010年底对国家登记册中的残疾退休事件(n = 628)进行了随访,并与基线数据相关联。排除后,参与者数量为6525。使用12项一般健康问卷(GHQ - 12)测量常见精神障碍。基线时的协变量包括社会人口统计学、工作相关和健康相关因素。使用Cox比例风险模型计算风险比(HR)和95%置信区间(CI)。

结果

常见精神障碍与残疾退休呈分级关联。对于任何诊断原因导致的残疾退休,GHQ - 12得分7 - 12的完全调整后HR为2.16,95% CI为1.63至2.85。对于因精神障碍导致的残疾退休,相应的HR为7.46,95% CI为4.46至12.49。对于因肌肉骨骼疾病导致的残疾退休,这种关联较弱,且在所有调整后不显著。

结论

常见精神障碍总体上是残疾退休的重要前驱因素,尤其是因精神障碍导致的残疾退休。针对常见精神障碍的成功措施可能预防因精神障碍导致的残疾退休。

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