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潜在创伤性事件对残疾抚恤金的预测作用:挪威一项为期 10 年的随访研究。

Potentially traumatic events as predictors of disability pension: A 10-year follow-up study in Norway.

机构信息

1 SINTEF Health, Norway.

2 University of Tromsø, Norway.

出版信息

Scand J Public Health. 2018 May;46(3):340-346. doi: 10.1177/1403494817722925. Epub 2017 Aug 2.

Abstract

AIMS

Are potentially traumatic events associated with subsequent disability pension? Traumatic exposure and post-traumatic stress disorder (PTSD) may represent a disabling state with both personal and professional consequences for the affected individual. Despite this, there is a scarcity of research studying the effects of traumatic exposure on disability pension. This study examined the differences in risk for disability pension among unexposed, exposed to trauma and PTSD cases.

METHODS

An ambidirectional Norwegian cohort study, consisting of 1238 individuals aged 18-66 years who were at risk of disability pension, were interviewed using the Composite International Diagnostic Interview, and linked with registry data on disability pension. Registry follow-up in the Norwegian Insurance Database lasted ten years following interview in 2000-01. The risk of disability pension after traumatic exposure, divided into accidental and premeditated, was assessed by Cox proportional hazards regression analysis.

RESULTS

In 10 years, 9.5% of the cohort had been granted disability pension. Overall exposure to traumatic events did not alter the risk of disability pension. However, among women, exposure to premeditated traumas did increase the risk (HR 2.96 (95% CI 1.54-5.68)), and was an independent risk factor. Fulfilling criteria for PTSD caseness further increased the risk (HR 4.69 (95% CI 1.78-12.40)). There was no increased risk found between traumatic exposure and disability pension for men.

CONCLUSIONS

Exposure to trauma, particularly premeditated trauma, seems to be an independent risk factor for disability pension in women.

摘要

目的

创伤后事件是否与随后的残疾抚恤金有关?创伤暴露和创伤后应激障碍(PTSD)可能代表一种致残状态,对受影响的个人具有个人和职业后果。尽管如此,研究创伤暴露对残疾抚恤金影响的研究很少。本研究检查了未暴露、创伤和 PTSD 病例暴露的个体残疾抚恤金风险的差异。

方法

这是一项双向挪威队列研究,包括 1238 名年龄在 18-66 岁之间、有残疾抚恤金风险的个体,他们使用复合国际诊断访谈进行了访谈,并与残疾抚恤金登记数据相关联。2000-01 年访谈后,挪威保险数据库中的登记随访持续了十年。通过 Cox 比例风险回归分析评估创伤暴露(分为意外和预谋)后的残疾抚恤金风险。

结果

在 10 年内,队列中有 9.5%的人获得了残疾抚恤金。总体创伤暴露并未改变残疾抚恤金的风险。然而,在女性中,预谋性创伤的暴露确实增加了风险(HR 2.96(95%CI 1.54-5.68)),并且是一个独立的风险因素。符合 PTSD 病例标准进一步增加了风险(HR 4.69(95%CI 1.78-12.40))。对于男性,没有发现创伤暴露与残疾抚恤金之间存在增加的风险。

结论

暴露于创伤,特别是预谋性创伤,似乎是女性残疾抚恤金的一个独立风险因素。

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