TY - JOUR PY - 2014// TI - Excess mortality after disability retirement due to mental disorders: Variations by socio-demographic factors and causes of death JO - Social psychiatry and psychiatric epidemiology A1 - Leinonen, Taina A1 - Martikainen, Pekka A1 - Laaksonen, Mikko A1 - Lahelma, Eero SP - 639 EP - 649 VL - 49 IS - 4 N2 - PURPOSE: Mental disorders are the key causes of disability retirement and are associated with a high risk of mortality. Social variations in excess mortality after disability retirement are nevertheless poorly understood. We examined socio-demographic differences in all-cause and cause-specific mortality after disability retirement due to depression and other mental disorders. METHODS: The data comprised a nationally representative sample of the Finnish population aged 25-64 in 1996 with no prior disability retirement due to mental disorders (N = 392,985). We used Cox regression analysis with disability retirement due to mental disorders as a time-varying covariate and mortality between 1997 and 2007 as the outcome variable. RESULTS: We found excess mortality after disability retirement due to mental disorders as compared to those with no such retirement in all specific causes of death, in particular alcohol-related causes, suicide, and other unnatural causes. Excess suicide mortality was particularly large after depression-based disability retirement. Younger age groups, non-manual classes, and those living with a partner and children had largest excess mortality, especially from unnatural and alcohol-related causes. However, the absolute number of excess deaths was not always largest in these socio-demographic groups. CONCLUSIONS: In young adulthood, disability retirement due to depression signifies severe health and other social disadvantages that lead to particularly large excess mortality, especially due to unnatural causes. The protective effects of a high socioeconomic position and family ties against unnatural and alcohol-related deaths are limited among those who have already developed depression or other mental disorders that have led to disability retirement.
Language: en
LA - en SN - 0933-7954 UR - http://dx.doi.org/10.1007/s00127-013-0747-2 ID - ref1 ER -