Faculty of Social Sciences, Tampere University, Tampere, Finland.
Tampere University Library, Tampere University, Tampere, Finland.
Eur J Public Health. 2020 Dec 11;30(6):1218-1224. doi: 10.1093/eurpub/ckaa132.
Previous research has identified low socioeconomic status (SES) as an epidemiological risk factor for early retirement and disability pension (DP) due to mental disorders. This study aims to examine these associations in greater detail, with separate consideration of the risk factors for mood disorders (F30-39) and non-affective psychotic disorder (F20-29) DP.
In this case-control setting the subjects (N = 36 879) were all those granted DP due to a mental disorder for the first time between 2010 and 2015 in Finland. All the subjects were matched with three controls for their gender, age and hospital district (N = 94 388). Three measures of dimensions of SES were used: education, income and occupational status, as well as family type as a control factor. Differences between DP recipients and controls, and between diagnostic groups, were studied using calculated characteristics and conditional logistic regression models.
DP recipients often lived alone and had low educational and income levels. These characteristics were more prominent in non-affective psychotic disorder than in mood disorder DP. In white-collar occupational groups, the risk of DP was greater compared with blue-collar workers. Students were associated with the highest level of risk for all mental and mood disorder DPs.
We found evidence of SES factors associating with mental disorder-related severe loss of working and studying ability in a disorder-specific way. Notably, white-collar workers had an increased risk of mental disorder DP. This could be related to the psychosocially demanding contemporary working life in non-manual work.
先前的研究已经确定，社会经济地位（SES）较低是由于精神障碍导致提前退休和残疾抚恤金（DP）的流行病学风险因素。本研究旨在更详细地研究这些关联，并分别考虑心境障碍（F30-39）和非情感性精神病性障碍（F20-29）DP 的风险因素。
在本病例对照研究中，研究对象（N=36879）均为芬兰在 2010 年至 2015 年间首次因精神障碍而首次获得 DP 的人群。所有研究对象均与性别、年龄和医院区域相匹配的 3 名对照者（N=94388）进行匹配。使用三种 SES 维度的测量方法：教育、收入和职业状况，以及家庭类型作为控制因素。使用计算特征和条件逻辑回归模型，研究 DP 接受者与对照组之间以及诊断组之间的差异。
DP 接受者通常独居，教育和收入水平较低。与心境障碍 DP 相比，这些特征在非情感性精神病性障碍 DP 中更为明显。在白领职业群体中，DP 的风险高于蓝领工人。与所有精神和心境障碍 DP 相比，学生的风险最高。
我们发现 SES 因素与特定精神障碍相关的严重丧失工作和学习能力有关。值得注意的是，白领工人患精神障碍 DP 的风险增加。这可能与非体力劳动中当代要求苛刻的心理社会工作生活有关。
