Common mental disorders and disability pension award: Seven year follow-up of the HUSK study
Common mental disorders and disability pension award: Seven year follow-up of the HUSK study
复制标题
DOI：
10.1016/j.jpsychores.2010.03.007
复制
发表时间：
2010-07-01
影响因子：
4.7
通讯作者：
Mykletun, Arnstein
中科院分区：
文献类型：
--
作者：
Knudsen, Ann Kristin;Overland, Simon;Mykletun, Arnstein
目标：在大多数发达国家，残疾养恤金发放率仍然很高。我们的目的是估计焦虑和抑郁对精神和身体诊断的DP的影响，并估计与病例级症状负荷相比，子病例级焦虑和抑郁的相对贡献。研究方法：一项关于40-46岁人群（N= 15，288）心理和身体健康的大型队列研究的信息与一个全面的国家残疾福利数据库相关联。病例水平和亚病例水平焦虑和抑郁分别定义为医院焦虑和抑郁量表评分>= 8和5-7。结局是在1-7年随访期间获得DP（包括ICD-10诊断）的事件。结果如下：根据基线时的病例水平焦虑[HR 1.90（95% CI 1.50-2.41）]、病例水平抑郁[HR 2.44（95% CI 1.65-3.59）]以及焦虑和抑郁共病[HR 4.92（95% CI 3.94-6.15）]预测所有诊断的DP奖励。通过调整基线躯体症状和诊断，仅部分解释了这些影响。焦虑和抑郁也可预测身体诊断的奖励[HR 3.26（95% CI 2.46-4.32）]。亚病例水平焦虑和抑郁症状负荷的人群归因分数（PAF）与病例水平症状负荷的人群归因分数（PAF焦虑0.07 vs 0.11，PAF抑郁0.05 vs 0.06）相当。结论：焦虑和抑郁症状的长期职业影响目前被低估了。焦虑和抑郁的子病例水平症状负荷对DP奖励做出了重要且先前未测量的贡献。(C)2010年爱思唯尔公司All rights reserved.
Objective: Rates of disability pension (DP) awards remain high in most developed countries. We aimed to estimate the impact of anxiety and depression on DPs awarded both for mental and for physical diagnoses and to estimate the relative contribution of sub case-level anxiety and depression compared with case-level symptom loads. Methods: Information from a large cohort study on mental and physical health in individuals aged 40-46 (N=15,288) was linked to a comprehensive national database of disability benefits. Case-level and sub case-level anxiety and depression were defined as scores on the Hospital Anxiety and Depression Scale of >= 8 and 5-7, respectively. The outcome was incident award of a DP (including ICD-10 diagnosis) during 1-7-year follow-up. Results: DP awards for all diagnoses were predicted both from case-level anxiety [HR 1.90 (95% CI 1.50-2.41)], case-level depression [HR 2.44 (95% CI 1.65-3.59] and comorbid anxiety and depression [HR 4.92 (95% CI 3.94-6.15)] at baseline. These effects were only partly accounted for by adjusting for baseline somatic symptoms and diagnoses. Anxiety and depression also predicted awards for physical diagnoses [HR 3.26 (95% CI 2.46-4.32)]. The population attributable fractions (PAF) of sub case-level anxiety and depression symptom loads were comparable to those from case-level symptom loads (PAF anxiety 0.07 versus 0.11, PAF depression 0.05 versus 0.06). Conclusion: The long-term occupational impact of symptoms of anxiety and depression is currently being underestimated. Sub case-level symptom loads of anxiety and depression make an important and previously unmeasured contribution to DP awards. (C) 2010 Elsevier Inc. All rights reserved.