@article{ref1,
title="Trajectories of work-related functional impairment prior to suicide",
journal="PLoS one",
year="2015",
author="Wang, Ming and Björkenstam, Charlotte and Alexanderson, Kristina and Runeson, Bo S. and Tinghög, Petter and Mittendorfer-Rutz, Ellenor",
volume="10",
number="10",
pages="e0139937-e0139937",
abstract="BACKGROUND: Work-related functional impairment in terms of sickness absence and disability pension (SA/DP) has been reported to be associated with subsequent suicide. However, there is only limited knowledge on SA/DP patterns prior to suicide. The aim was to identify trajectories of work-related functional impairment prior to suicide and to describe associations of socio-demographic and medical factors with such trajectories. <br><br>METHODS: This is a population-based retrospective cohort study of the 4 209 individuals aged 22-65 years who committed suicide during 2007-2010 in Sweden. Work-related functional impairment was measured as mean annual number of months of SA/DP. We analyzed trajectories of SA/DP during five years prior to suicide (i.e., 2002-2009) by a group-based trajectory method. Associations between socio-demographic and medical factors with different groups of trajectories were estimated by chi2-test and multinomial logistic regression. <br><br>RESULTS: Five different functional impairment trajectory groups were identified prior to suicide. One group had constant low levels of SA/DP (46%), while 30% had constant high levels of SA/DP. Two groups (16%) showed increasing number of SA/DP months. The remaining 7% showed decreasing number of SA/DP months before the suicide. Sex, age, educational level, family situation, and diagnosis-specific healthcare were significantly associated with different trajectory groups (Likelihood ratio X2 tests <0.05). A larger proportion of higher educated and younger men with a lower proportion of previous suicide attempts were found in the group with constant low levels. Opposite characteristics were displayed in the group with constant high levels. <br><br>CONCLUSIONS: This study identified five different groups of work-related functional impairment trajectories before suicide. These differences might be partly explained by the variations in socio-demographic profiles and health care consumptions five years before suicide.<p /> <p>Language: en</p>",
language="en",
issn="1932-6203",
doi="10.1371/journal.pone.0139937",
url="http://dx.doi.org/10.1371/journal.pone.0139937"
}