Is retirement beneficial for mental health?: antidepressant use before and after retirement

Abstract

Background: Recent studies based on self-reported data suggest that retirement may have beneficial effects on mental health, but studies using objective endpoints remain scarce. This study examines longitudinally the changes in antidepressant medication use across the 9 years spanning the transition to retirement.

Methods: Participants were Finnish public-sector employees: 7138 retired at statutory retirement age (76% women; mean age, 61.2 years), 1238 retired early due to mental health issues (78% women; mean age, 52.0 years), and 2643 retired due to physical health issues (72% women; mean age, 55.4 years). Information on purchase of antidepressant medication 4 years before and 4 years after retirement year was based on comprehensive national pharmacy records in 1994-2005.

Results: One year before retirement, the use of antidepressants was 4% among those who would retire at statutory age, 61% among those who would retire due to mental health issues, and 14% among those who would retire due to physical health issues. Retirement-related changes in antidepressant use depended on the reason for retirement. Among old-age retirees, antidepressant medication use decreased during the transition period (age- and calendar-year-adjusted prevalence ratio for antidepressant use 1 year after versus 1 year before retirement = 0.77 [95% confidence interval = 0.68 to 0.88]). Among those whose main reason for disability pension was mental health issues or physical health issues, there was an increasing trend in antidepressant use prior to retirement and, for mental health retirements, a decrease after retirement.

Conclusions: Trajectories of recorded purchases of antidepressant medication are consistent with the hypothesis that retirement is beneficial for mental health.

Figure 1

Prevalence of antidepressant and diabetes medication use adjusted for calendar year and retirement age, in relation to year of retirement at statutory age (error bars indicate 95% confidence intervals). Note that the figure is corrected for the increasing secular trend in prescriptions during the study period.

Figure 2

Prevalence of antidepressant use in relation to year of early retirement due to mental causes and physical causes separately and prevalence of use of drugs for diabetes in both these cohorts combined, adjusted for retirement age and calendar year. Error bars indicate 95% confidence intervals. Note that the figure is corrected for the increasing secular trend in prescriptions during the study period. (Notice that the scale for y-axis is different than in Figure 1.)