Rissanen Päivi, Pirkola Sami, Näppilä Turkka, Karolaakso Tino, Leppänen Helena, Fröjd Sari, Autio Reija
Faculty of Social Sciences (Unit of Health Sciences), Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland.
Department of Psychiatry, The Wellbeing Services County of Pirkanmaa, Tampere, Finland.
J Occup Rehabil. 2025 Aug 11. doi: 10.1007/s10926-025-10312-4.
Mental health-related work disability has increased in Europe, despite efforts to promote individuals´ work ability. We examined individuals´ occupational status before and after a psychiatric disability pension (DP).
The study comprises individuals granted a DP for the first time between 2010 and 2012 in Finland (N = 18,373). We used modern methods to cluster the sequences of individuals´ occupational status before and after temporary (n = 8615) or permanent (n = 9758) psychiatric DP. We compared socioeconomic, illness and health care system-related factors between nine groups, formed by sequence analysis utilizing multinominal regression analysis.
The analysis identified typical groups of temporary pensioners: after steady working careers, periods of unemployment and from mixed states. Severity of health and mental health problems, socioeconomic and occupational status, pension system-related factors as well as treatment or rehabilitation varied between the groups. Individuals with temporary DPs (tDP) appeared mainly to either remain disabled (74% of the study tDP) or return to the same status they had before disability: to work (17%) or unemployment (8%). A steady working career, high education and received psychotherapy and rehabilitation all promoted returning to work. Among young adults, severity of the illness and lack of occupational education were risk factors for long-term disability.
Among those with tDP, circles of disadvantage may exist. They relate to unemployment, poor mental and somatic heath, low education, poverty, and failure of rehabilitative efforts. Especially young adults with severe mental disorders require not only rehabilitation but also educational support.
尽管欧洲为提高个人工作能力做出了努力，但与心理健康相关的工作残疾情况仍有所增加。我们研究了个体在获得精神残疾抚恤金（DP）前后的职业状况。
该研究纳入了2010年至2012年期间在芬兰首次获得DP的个体（N = 18373）。我们使用现代方法对个体在临时（n = 8615）或永久（n = 9758）精神DP前后的职业状况序列进行聚类。我们通过多分类回归分析利用序列分析形成的九组之间比较了社会经济、疾病和医疗系统相关因素。
分析确定了临时领取抚恤金者的典型群体：在稳定的工作生涯之后、经历失业期以及处于混合状态的群体。不同群体在健康和心理健康问题的严重程度、社会经济和职业状况、与抚恤金制度相关的因素以及治疗或康复方面存在差异。临时DP个体（tDP）主要表现为要么持续残疾（研究中tDP的74%），要么恢复到残疾前的相同状态：工作（17%）或失业（8%）。稳定的工作生涯、高学历以及接受心理治疗和康复都有助于重返工作岗位。在年轻人中，疾病严重程度和缺乏职业教育是长期残疾的风险因素。
在tDP个体中可能存在劣势循环。它们与失业
