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. 2022 May;95(4):867-876.
doi: 10.1007/s00420-021-01825-5. Epub 2021 Dec 28.

Role of social benefits for future long-term sickness absence, disability pension and unemployment among individuals on sickness absence due to mental diagnoses: a competing risk approach

Annina Ropponen  1   2 , Jurgita Narusyte  3   4 , Mo Wang  3 , Sanna Kärkkäinen  3   5 , Lisa Mather  3 , Victoria Blom  3   6 , Gunnar Bergström  7   8 , Pia Svedberg  3
Affiliations

Role of social benefits for future long-term sickness absence, disability pension and unemployment among individuals on sickness absence due to mental diagnoses: a competing risk approach

Annina Ropponen et al. Int Arch Occup Environ Health. 2022 May.

Abstract

Purpose: To investigate associations between social benefits and disability pension (DP), long-term sickness absence (LTSA, ≥ 90 days), or unemployment among Swedish twins with sickness absence (SA) due to mental diagnoses.

Methods: This population-based prospective twin study included register data on first incident SA spell (< 90 days) due to mental diagnoses (ICD 10 codes F00-F99) during the follow-up 2005-2016. SA < 90 days due to other diagnoses than mental diagnoses or any other social insurance benefit was identified for the preceding year of the first incident SA spell due to mental diagnoses (coded yes/no). Comparing those with any previous social benefits vs without, cumulative incidence curve to compare time to an event, and Cox proportional hazards models for cause-specific hazard ratios (HR, 95% confidence intervals, CI) treating first incident DP, LTSA and unemployment as competing risks were modeled.

Results: During follow-up, 21 DP, 1619 LTSA, and 808 unemployment events took place. Compared to those without, those with at least one benefit had a higher risk for DP (HR 5.03; 95%CI 1.80, 14.01), LTSA (1.67; 1.50, 1.84) and unemployment (1.24; 1.03, 1.50). The cumulative incidence for DP was very low, < 1%, for LTSA 80% with any previous social benefits vs. 60% without, and for unemployment ≤ 5%.

Conclusion: Social benefits received during the preceding year of SA due to mental diagnoses (< 90 days) predict DP, LTSA, and unemployment. Hence, previous social benefits may provide means for early identification of persons at risk for exit from labor market.

Keywords: Disability pension; Mental diagnoses; Sick leave; Sickness absence; Unemployment.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
The analytic strategy among those who had the first incident SA spell (< 90 days) due to mental diagnoses since 2005. Censoring has not been accounted in this figure
Fig. 2
Fig. 2
Cumulative incidence of long-term (> 90 days) sickness absence, disability pension or unemployment during the follow-up, stratified using the previous social benefits, among individuals with SA < 90 days due to mental diagnoses
See this image and copyright information in PMC

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