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Adverse outcomes of sick leave due to mental disorders: A prospective study of discordant twin pairs.
Karolinska institutet.
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska institutet, Stockholms universitet.ORCID iD: 0000-0002-0079-124X
Karolinska institutet.
Karolinska institutet.
2017 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, 1403494817735755Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIMS: The aim of this study was to investigate whether sick leave due to different mental disorders increased the risk of reoccurring sick-leave, disability pension and unemployment, taking genetics and shared environment into account.

METHODS: This register-based cohort study contains 2202 discordant twin pairs 18-64 years old, where one twin had sick leave due to a mental disorder 2005-2006. The end of the sick-leave spell was the start of follow-up for both twins. The twins were followed up for reoccurring sick-leave, disability pension and unemployment (> 180 days in a year), until December 2012. Analyses were censored for disability pension, death, emigration and old-age pension. Cox proportional hazards models with time-varying covariates were used to calculate hazard ratios with 95% confidence intervals (CI).

RESULTS: Those with sick leave due to mental disorders had a 3.64 (CI: 3.24-4.08) times higher risk of reoccurring sick-leave within the first two years; after that, hazard ratios were attenuated and explained by genetic factors. The first year, they had 12.24 (CI: 8.11-18.46) times the risk of disability pension. The risk was attenuated but remained at 2.75 (CI: 2.07-3.65) after one year. The risk of unemployment was 1.99 (CI: 1.72-2.31) during the whole follow-up period. The risk of unemployment and disability pension was lower for those with stress-related than other mental disorders, this was less clear for recurrent reoccuring sick-leave.

CONCLUSIONS: Sick leave due to mental disorders increased the risk of reoccurring sick-leave within two years, disability pension and unemployment, independent of genetics and shared environment.

Place, publisher, year, edition, pages
2017. 1403494817735755
Keyword [en]
Sick Leave, disability insurance, mental disorders, twins, unemployment
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
URN: urn:nbn:se:gih:diva-5058DOI: 10.1177/1403494817735755PubMedID: 29032743OAI: oai:DiVA.org:gih-5058DiVA: diva2:1154947
Available from: 2017-11-06 Created: 2017-11-06 Last updated: 2017-11-06Bibliographically approved

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