Lie Stein Atle, Tveito Torill H, Reme Silje E, Eriksen Hege R
Uni Research Health, Bergen, Norway.
Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
PLoS One. 2017 Jul 6;12(7):e0180737. doi: 10.1371/journal.pone.0180737. eCollection 2017.
Disability benefits and sick leave benefits represents huge costs in western countries. The pathways and prognostic factors for receiving these benefits seen in recent years are complex and manifold. We postulate that mental health and IQ, both alone and concurrent, influence subsequent employment status, disability benefits and mortality.
A cohort of 918 888 Norwegian men was followed for 16 years from the age of 20 to 55. Risk for health benefits, emigration, and mortality were studied. Indicators of mental health and IQ at military enrolment were used as potential risk factors. Multi-state models were used to analyze transitions between employment, sick leave, time limited benefits, disability benefits, emigration, and mortality.
During follow up, there were a total of 3 908 397 transitions between employment and different health benefits, plus 12 607 deaths. Men with low IQ (below 85), without any mental health problems at military enrolment, had an increased probability of receiving disability benefits before the age of 35 (HRR = 4.06, 95% CI: 3.88-4.26) compared to men with average IQ (85 to 115) and no mental health problems. For men with both low IQ and mental health problems, there was an excessive probability of receiving disability benefits before the age of 35 (HRR = 14.37, 95% CI: 13.59-15.19), as well as an increased probability for time limited benefits and death before the age of 35 compared to men with average IQ (85 to 115) and no mental health problems.
Low IQ and mental health problems are strong predictors of future disability benefits and early mortality for young men.
在西方国家，残疾福利和病假福利成本巨大。近年来，获得这些福利的途径和预后因素复杂多样。我们推测，心理健康和智商，无论是单独还是共同作用，都会影响随后的就业状况、残疾福利和死亡率。
对918888名挪威男性队列进行了16年的随访，从20岁到55岁。研究了健康福利、移民和死亡风险。将入伍时的心理健康和智商指标用作潜在风险因素。使用多状态模型分析就业、病假、限时福利、残疾福利、移民和死亡之间的转变。
在随访期间，就业与不同健康福利之间总共发生了3908397次转变，另有12607人死亡。智商低（低于85）且入伍时无任何心理健康问题的男性，与智商平均（85至115）且无心理健康问题的男性相比，在35岁之前获得残疾福利的概率增加（风险比=4.06，95%置信区间：3.88-4.26）。对于智商低且有心理健康问题的男性，与智商平均（85至115）且无心理健康问题的男性相比，在35岁之前获得残疾福利的概率过高（风险比=14.37，95%置信区间：13.59-15.19），并且在35岁之前获得限时福利和死亡的概率也增加。
低智商和心理健康问题是年轻男性未来残疾福利和早死的有力预测因素。
