CoChat
Sign Up
Cited by 72Personality Disorders and PsychopathologyRetirement, Disability, and EmploymentPersonality Traits and Psychology

Personality disorders are important risk factors for disability pensioning

Open access
Østby, Kristian Amundsen, Czajkowski, Nikolai, Knudsen, Gun Peggy, Ystrom, Eivind, Gjerde, Line C., Kendler, Kenneth S., Ørstavik, Ragnhild E., Reichborn-Kjennerud, Ted·2014·Social Psychiatry and Psychiatric Epidemiology
DOI 10.1007/s00127-014-0878-0PMC PMC4218874
Open this paper in CoChat — free account

Abstract

Purpose To determine whether personality disorders (PDs) are associated with increased risk of disability pensioning in young adults, independent of other common mental disorders.Methods 2,770 young adults from the general population were assessed for PDs by the Structured Interview for DSM-IV Personality, and for common mental disorders by the Composite of International Diagnostic Interview. These data were linked to the Norwegian National Insurance Administration's recordings of disability benefits for a 10-year period. Logistic regression analyses were applied to investigate the association between PDs and disability pensioning. The analyses were conducted for three types of PD measures: categorical diagnoses (any PD), dimensional scores of individual PDs and higher order components retrieved by principal component analyses.Results Having any PD was strongly associated with disability pensioning, regardless of disability diagnosis. The estimated odds ratio (OR) was substantially higher for PDs [OR 4.69 (95% confidence interval (CI) 2.6-8.5)] than for mood disorders [OR 1.3 (CI 0.7-2.3)] and anxiety disorders [OR 2.3 (CI 1.3-4.3)]. Measured dimensionally, all PD traits except antisocial traits were significantly associated with disability pensioning. After adjusting for co-occurring traits of other PDs, only schizoid, dependent and borderline PD traits showed a significant positive association with disability pension, while antisocial traits showed a significant negative association. The principal component analyses showed that negative affectivity, psychoticism, and detachment was associated with an increased risk of disability pensioning, while antagonism/disinhibition and obsessivity were not.Conclusions PDs are strongly associated with disability pensioning in young adults, and might be more important predictors of work disability than anxiety and depressive disorders. Certain aspects of pathologic personalities are particularly important predictors of disability.

Integrity signals

Registry

Crossref · 10.1007/s00127-014-0878-0

Cites

43 of 43 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 56 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In young adults, having any personality disorder is associated with increased odds of disability pensioning.

    “Having any PD was strongly associated with disability pensioning, regardless of disability diagnosis.”
    • Also stated in: § Discussion · boosted
      “PDs showed a strong and significant association with disability pensioning, both when measured categorically and dimensionally.”
    Quote in the paperSubstantial claim
  • Findingown data

    Among participants with a disability pension, 26.3% had at least one personality disorder.

    “Among those with a disability pension, 26.3 % had at least one PD.”
    Quote in the paperSubstantial claim
  • Findingown data

    In principal component analysis, antagonism/disinhibition and obsessivity were not significantly associated with disability pensioning.

    “while antagonism/disinhibition and obsessivity were not.”
    • Also stated in: § Results · plain
      “while obsessivity and antagonism/disinhibition showed no significant association.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In principal component analysis, negative affectivity, psychoticism and detachment were associated with increased risk of disability pensioning.

    “The principal component analyses showed that negative affectivity, psychoticism, and detachment was associated with an increased risk of disability pensioning, while antagonism/disinhibition and obsessivity were not.”
    • Also stated in: § Results · plain
      “The negative affectivity, psychoticism and detachment components were positively and significantly associated with disability pensioning (Table 5), while obsessivity and antagonism/disinhibition showed no significant association.”
    Quote in the paperNot a substantial claim
  • Findingreasoning

    The antagonism/disinhibition component was not associated with increased risk of disability pensioning.

    “Antagonism/disinhibition was not associated with an increased risk of disability pensioning.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 19
  • May combine two claims. 22
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    The prevalence of having at least one personality disorder in this sample was 5.1%, similar to previous studies.

    “The prevalence of having at least one PD was 5.1 %, which is similar to what have been found in previous studies [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Coid J, Yang M, Tyrer P, Roberts A, Ullrich S (2006) Prevalence and correlates of personality disorder in Great Britain. Br J Psychiatry 188:423–431 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The detachment component was dominated by schizoid and schizotypal traits, also had a considerable avoidant loading, and is characterized by social withdrawal.

    “Component 4, labelled detachment, comprised schizoid (0.84) and schizotypal (0.41) traits.”
    • Also stated in: § Discussion · plain
      “Detachment was dominated by schizoid and schizotypal traits, but also had a considerable loading from avoidant PD. This component is characterized by social withdrawal, and schizoid PD had the strongest loading on this component.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The psychoticism component was dominated by paranoid, schizotypal and borderline traits and is characterized by cognitive dysregulation and unusual thoughts or beliefs.

    “Component 2, labelled psychoticism, comprised paranoid (0.80), schizotypal (0.74) and borderline (0.45) traits.”
    • Also stated in: § Discussion · plain
      “Psychoticism was dominated by paranoid, schizotypal and borderline traits, and is characterized by cognitive dysregulation and strange or uncommon thoughts or beliefs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The negative affectivity component was dominated by dependent, avoidant and borderline traits and is characterized by negative emotions.

    “Component 1 was labelled negative affectivity and comprised mainly dependent traits (component loading 0.86), avoidant traits (0.76) and borderline traits (0.42).”
    • Also stated in: § Discussion · plain
      “Negative affectivity was dominated by dependent, avoidant and borderline traits, and is characterized by negative emotions.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    The association between any personality disorder and disability pensioning is stronger than the association for mood disorders.

    “The estimated odds ratio (OR) was substantially higher for PDs [OR 4.69 (95 % confidence interval (CI) 2.6–8.5)] than for mood disorders [OR 1.3 (CI 0.7–2.3)] and anxiety disorders [OR 2.3 (CI 1.3–4.3)].”
    • Also stated in: § Discussion · plain
      “The association with disability pensioning was significantly stronger for PDs than for mood disorders.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The odds ratio for any personality disorder was higher than for anxiety disorders, but the confidence intervals overlapped.

    “The ORs were also higher for PDs than for anxiety disorders, but the confidence intervals were overlapping.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Post hoc analyses showed that adjustment for borderline traits was sufficient to reveal the negative association between antisocial traits and disability pensioning, also when each gender was analysed separately.

    “Post hoc analyses showed that adjusting for borderline traits was enough to bring out the negative association between antisocial traits and disability pensioning, also when analysing each gender separately.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Disability pension receipt was 1.1% in the highest socioeconomic status group and 4.9% in the lowest socioeconomic status group.

    “In the highest SES group 1.1 % received disability pension, compared to 4.9 % in the lowest SES group.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The obsessivity component comprised obsessive-compulsive (0.79), narcissistic (0.73) and histrionic (0.63) traits.

    “Component 5, labelled obsessivity, comprised obsessive–compulsive (0.79), narcissistic (0.73) and histrionic (0.63) traits.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The principal component analysis retained five components, with a Kaiser-Meyer-Olkin measure of 0.82, eigenvalues of 3.78, 1.34, 0.95, 0.86 and 0.68, and cumulative explained variance of 76%.

    “In the principal component analysis, the most meaningful model with the fewest cross loadings had five components (Table 4). The KaiseRMeyeROlkin measure for this model was 0.82, and the Eigenvalues for the five components were 3.78, 1.34, 0.95, 0.86, and 0.68, with a cumulative explained variance of 76 %.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study is population-based, focuses on young adults, uses accurate objective registry data on disability pensioning, and uses diagnostic interviews for psychiatric disorders.

    “This study has several strengths. First of all, it is a population based study with a focus on young adults, a demographic group that may be at particular risk for disability pensioning due to mental disorders. In addition, it utilizes accurate and objective data from official Norwegian registries on disability pensioning, and uses diagnostic interviews for measures of psychiatric disorders.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Personality disorders have a well-known association with functional impairment.

    “Although PDs have a well-known association with functional impairment [17–20]”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [17] Coid J, Yang M, Tyrer P, Roberts A, Ullrich S (2006) Prevalence and correlates of personality disorder in Great Britain. Br J Psychiatry 188:423–431 source

      Not checked in the free run.

    • cites [18] Grant BF, Hasin DS, Stinson FS, Dawson DA, Chou SP, Ruan WJ, Pickering RP (2004) Prevalence, correlates, and disability of personality disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 65:948–958 source

      Not checked in the free run.

    • cites [19] Hengartner MP, Muller M, Rodgers S, Rossler W, Ajdacic-Gross V (2014) Occupational functioning and work impairment in association with personality disorder trait-scores. Soc Psychiatry Psychiatr Epidemiol 49:327–335 source

      Not checked in the free run.

    • cites [20] Skodol AE, Bender DS, Morey LC, Clark LA, Oldham JM, Alarcon RD, Krueger RF, Verheul R, Bell CC, Siever LJ (2011) Personality disorder types proposed for DSM-5. J Pers Disord 25:136–169 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Personality disorders have been associated with similar or higher societal costs than mood and anxiety disorders.

    “Personality disorders (PDs) are now being accepted as important conditions in mainstream psychiatry and have been associated with similar or higher costs to society than mood and anxiety disorders [9–11]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [9] Huang Y, Kotov R, de GG, Preti A, Angermeyer M, Benjet C, Demyttenaere K, de GR, Gureje O, Karam AN, Lee S, Lepine JP, Matschinger H, Posada-Villa J, Suliman S, Vilagut G, Kessler RC (2009) DSM-IV personality disorders in the WHO World Mental Health Surveys. Br J Psychiatry 195:46–53 source

      Not checked in the free run.

    • cites [10] Soeteman DI, Hakkaart-van Roijen L, Verheul R, Busschbach JJV (2008) The economic burden of personality disorders in mental health care. J Clin Psychiatry 69:259–265 source

      Not checked in the free run.

    • cites [11] Tyrer P, Mulder R, Crawford M, Newton-Howes G, Simonsen E, Ndetei D, Koldobsky N, Fossati A, Mbatia J, Barrett B (2010) Personality disorder: a new global perspective. World Psychiatry 9:56–60 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Personality disorders as classified in DSM-IV affect about 6% of the world's population.

    “PDs as currently classified in the DSM-IV system affects about 6 % of the world’s population [9, 11]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [9] Huang Y, Kotov R, de GG, Preti A, Angermeyer M, Benjet C, Demyttenaere K, de GR, Gureje O, Karam AN, Lee S, Lepine JP, Matschinger H, Posada-Villa J, Suliman S, Vilagut G, Kessler RC (2009) DSM-IV personality disorders in the WHO World Mental Health Surveys. Br J Psychiatry 195:46–53 source

      Not checked in the free run.

    • cites [11] Tyrer P, Mulder R, Crawford M, Newton-Howes G, Simonsen E, Ndetei D, Koldobsky N, Fossati A, Mbatia J, Barrett B (2010) Personality disorder: a new global perspective. World Psychiatry 9:56–60 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    Detailed analyses of non-response predictors in this twin panel showed that further participation was strongly predicted by sex, zygosity, age and education, but not by psychiatric symptoms.

    “detailed analyses of the predictors of non-response in this twin panel revealed that further participation was strongly predicted by sex, zygosity, age and education, but not by psychiatric symptoms [34].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [34] Tambs K, Ronning T, Prescott CA, Kendler KS, Reichborn-Kjennerud T, Torgersen S, Harris JR (2009) The Norwegian Institute of Public Health twin study of mental health: examining recruitment and attrition bias. Twin Res Hum Genet 12:158–168 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Inter-rater reliability for the number of endorsed personality disorder criteria at the subthreshold level was assessed on 70 audiotaped interviews, with intra-class correlations from +0.81 to +0.96.

    “Inter-rater reliability was assessed by two raters scoring 70 audiotaped interviews. Intra-class correlations for the number of endorsed criteria at the subthreshold level ranged from +0.81 to +0.96.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    All variance inflation factors were below 2.0, indicating no multicollinearity problem in the multiple regression analyses.

    “All VIFs were below 2.0, indicating that we did not have a problem with multicollinearity in our analyses.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    Personality disorders might be particularly important risk factors in younger age groups because work-related disability has a greater impact and early onset imposes a greater economic burden.

    “Because the impact of work related disability is more dramatic in the lives of young individuals, and the economic burden on society is greater with early onset, PDs might be particularly important risk factors in the younger age groups.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Common mental disorders are among the most important predictors of disability pensioning, especially in younger age groups, and associations are significant regardless of whether pensions are awarded for somatic or psychiatric disorders.

    “Common mental disorders are among the most important predictors of disability pensioning [3–6]; especially, in the younger age groups [7], and associations are significant regardless of whether the pensions are awarded for somatic or psychiatric disorders [8].”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [3] Gjesdal S, Ringdal PR, Haug K, Maeland JG (2008) Long-term sickness absence and disability pension with psychiatric diagnoses: a population-based cohort study. Nord J Psychiatry 62:294–301 source

      Not checked in the free run.

    • cites [4] Karpansalo M, Kauhanen J, Lakka TA, Manninen P, Kaplan GA, Salonen JT (2005) Depression and early retirement: prospective population based study in middle aged men. J Epidemiol Community Health 59:70–74 source

      Not checked in the free run.

    • cites [5] Knudsen AK, Overland S, Aakvaag HF, Harvey SB, Hotopf M, Mykletun A (2010) Common mental disorders and disability pension award: seven year follow-up of the HUSK study. J Psychosom Res 69:59–67 source

      Not checked in the free run.

    • cites [6] Mykletun A, Heradstveit O, Eriksen K, Glozier N, Overland S, Maeland JG, Wilhelmsen I (2009) Health anxiety and disability pension award: the HUSK study. Psychosom Med 71:353–360 source

      Not checked in the free run.

    • cites [7] Mykletun A, Knudsen AK (2009) Tapte arbeidsår ved uførepensjonering for psykiske lidelser. Norwegian institute of public health, Norway

      Not checked in the free run.

    • cites [8] Mykletun A, Overland S, Dahl AA, Krokstad S, Bjerkeset O, Glozier N, Aaro LE, Prince M (2006) A population-based cohort study of the effect of common mental disorders on disability pension awards. Am J Psychiatry 163:1412–1418 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Because the UK study assessed personality disorders with screening questionnaires rather than diagnostic interviews, it included less severe cases and probably underestimated the association.

    “Because assessments of PDs were based on screening questionnaires rather than diagnostic interviews, the study included less severe cases of PDs. This probably led to an underestimation of the association.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Knudsen AK, Skogen JC, Harvey SB, Stewart R, Hotopf M, Moran P (2012) Personality disorders, common mental disorders and receipt of disability benefits: evidence from the British National Survey of Psychiatric Morbidity. Psychol Med 42:1–10 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The Norwegian National Insurance Administration registries are updated annually and their accuracies are well documented.

    “The registries of NIA are updated annually, and their accuracies are well documented [24].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] Akselsen A, Lien S, Sandnes T (2003) FD-trygd dokumentasjonsrapport. Pensjoner. Grunn og hjelpestønader 1992–2001. Rikstrygdeverket, Norway

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The UK study found that individuals screening positive for probable personality disorders were significantly more likely to receive disability benefits, especially with co-morbid psychiatric disorders.

    “Using data from the British National Survey of Psychiatric Morbidity, the authors found that individuals screening positive for probable PDs were significantly more likely to receive disability benefits; especially, in the presence of co-morbid psychiatric disorders.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Knudsen AK, Skogen JC, Harvey SB, Stewart R, Hotopf M, Moran P (2012) Personality disorders, common mental disorders and receipt of disability benefits: evidence from the British National Survey of Psychiatric Morbidity. Psychol Med 42:1–10 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Adjusting for mood and anxiety disorders may be overly conservative because personality disorder symptoms overlap with anxiety and depression, potentially underestimating the true effects of personality disorders.

    “The symptoms might therefore work as mediators instead of confounders, making the adjustments overly conservative and underestimating the true effects of PDs.”
    Quote in the paperNot a substantial claim0 of 8 sources checked
    • cites [35] Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD, Smith SM, Dawson DA, Pulay AJ, Pickering RP, Ruan WJ (2008) Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 69:533–545 source

      Not checked in the free run.

    • cites [36] Reichborn-Kjennerud T, Czajkowski N, Roysamb E, Orstavik RE, Neale MC, Torgersen S, Kendler KS (2010) Major depression and dimensional representations of DSM-IV personality disorders: a population-based twin study. Psychol Med 40:1475–1484 source

      Not checked in the free run.

    • cites [37] Stinson FS, Dawson DA, Goldstein RB, Chou SP, Huang B, Smith SM, Ruan WJ, Pulay AJ, Saha TD, Pickering RP, Grant BF (2008) Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 69:1033–1045 source

      Not checked in the free run.

    • cites [38] Vilaplana M, McKenney K, Riesco MD, Autonell J, Cervilla JA (2010) Depressive comorbidity in personality disorders. Revista de Psiquiatria y Salud Mental 3:4–12 source

      Not checked in the free run.

    • cites [3] Gjesdal S, Ringdal PR, Haug K, Maeland JG (2008) Long-term sickness absence and disability pension with psychiatric diagnoses: a population-based cohort study. Nord J Psychiatry 62:294–301 source

      Not checked in the free run.

    • cites [4] Karpansalo M, Kauhanen J, Lakka TA, Manninen P, Kaplan GA, Salonen JT (2005) Depression and early retirement: prospective population based study in middle aged men. J Epidemiol Community Health 59:70–74 source

      Not checked in the free run.

    • cites [5] Knudsen AK, Overland S, Aakvaag HF, Harvey SB, Hotopf M, Mykletun A (2010) Common mental disorders and disability pension award: seven year follow-up of the HUSK study. J Psychosom Res 69:59–67 source

      Not checked in the free run.

    • cites [6] Mykletun A, Heradstveit O, Eriksen K, Glozier N, Overland S, Maeland JG, Wilhelmsen I (2009) Health anxiety and disability pension award: the HUSK study. Psychosom Med 71:353–360 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Effective therapies have become available for the treatment of several personality disorders.

    “During the past two decades, effective therapies have become available for the treatment of several PDs [14–16].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [14] Dimeff LA, McDavid J, Linehan MM (1999) Pharmacotherapy for borderline personality disorder: a review of the literature and recommendations for treatment. J Clin Psychol Med Settings 6:113–138 source

      Not checked in the free run.

    • cites [15] Hofmann SG, Asnaani A, Vonk IJJ, Sawyer AT, Fang A (2012) The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cogn Ther Res 36:427–440 source

      Not checked in the free run.

    • cites [16] Leichsenring F, Leibing E, Kruse J, New AS, Leweke F (2011) Borderline personality disorder. Lancet 377:74–84 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Some findings for individual personality disorder traits might not apply to people with severe personality pathology.

    “but still, some of our findings for individual sets of PD traits might not apply to people with severe personality pathology.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Personality disorders are relatively common in the community, and effective treatment is available for some.

    “As PDs are relatively common in the community, and effective treatment is available for some, health care workers should be aware of the strong link between PDs and work force exclusion.”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [9] Huang Y, Kotov R, de GG, Preti A, Angermeyer M, Benjet C, Demyttenaere K, de GR, Gureje O, Karam AN, Lee S, Lepine JP, Matschinger H, Posada-Villa J, Suliman S, Vilagut G, Kessler RC (2009) DSM-IV personality disorders in the WHO World Mental Health Surveys. Br J Psychiatry 195:46–53 source

      Not checked in the free run.

    • cites [11] Tyrer P, Mulder R, Crawford M, Newton-Howes G, Simonsen E, Ndetei D, Koldobsky N, Fossati A, Mbatia J, Barrett B (2010) Personality disorder: a new global perspective. World Psychiatry 9:56–60 source

      Not checked in the free run.

    • cites [14] Dimeff LA, McDavid J, Linehan MM (1999) Pharmacotherapy for borderline personality disorder: a review of the literature and recommendations for treatment. J Clin Psychol Med Settings 6:113–138 source

      Not checked in the free run.

    • cites [15] Hofmann SG, Asnaani A, Vonk IJJ, Sawyer AT, Fang A (2012) The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cogn Ther Res 36:427–440 source

      Not checked in the free run.

    • cites [16] Leichsenring F, Leibing E, Kruse J, New AS, Leweke F (2011) Borderline personality disorder. Lancet 377:74–84 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The results may not apply to other age and ethnic groups.

    “but our results may not apply to other age- and ethnic groups.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Specific phobias were excluded from the anxiety disorder measure because they were very common and unlikely to cause disability pensioning.

    “Specific phobias were not included because they were very common and unlikely to cause disability pensioning.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The lack of association for obsessivity supports the multiple regression finding that obsessive-compulsive, narcissistic and histrionic personality disorders had an initial positive association that disappeared after adjustment for co-morbid traits.

    “This supports the findings from our multiple regression analyses, where all these three PDs had an initial positive association with disability pensioning that disappeared when adjusting for co-morbid traits of other PDs (Table 3, model 3).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Personality disorder symptoms are thought to be present from early adulthood, and the interview measures symptoms from the past five years.

    “However, symptoms of PDs are thought to be present from early adulthood, and the interview intends to measure symptoms of PDs from the past 5 years.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Personality disorders are highly co-morbid with anxiety and depression, and these disorders are known to be associated with increased risk of disability pensioning.

    “PDs are highly co-morbid with anxiety and depression [35–38], and these disorders are known to be associated with an increased risk of disability pensioning [3–6].”
    Quote in the paperSubstantial claim0 of 8 sources checked
    • cites [35] Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD, Smith SM, Dawson DA, Pulay AJ, Pickering RP, Ruan WJ (2008) Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 69:533–545 source

      Not checked in the free run.

    • cites [36] Reichborn-Kjennerud T, Czajkowski N, Roysamb E, Orstavik RE, Neale MC, Torgersen S, Kendler KS (2010) Major depression and dimensional representations of DSM-IV personality disorders: a population-based twin study. Psychol Med 40:1475–1484 source

      Not checked in the free run.

    • cites [37] Stinson FS, Dawson DA, Goldstein RB, Chou SP, Huang B, Smith SM, Ruan WJ, Pulay AJ, Saha TD, Pickering RP, Grant BF (2008) Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 69:1033–1045 source

      Not checked in the free run.

    • cites [38] Vilaplana M, McKenney K, Riesco MD, Autonell J, Cervilla JA (2010) Depressive comorbidity in personality disorders. Revista de Psiquiatria y Salud Mental 3:4–12 source

      Not checked in the free run.

    • cites [3] Gjesdal S, Ringdal PR, Haug K, Maeland JG (2008) Long-term sickness absence and disability pension with psychiatric diagnoses: a population-based cohort study. Nord J Psychiatry 62:294–301 source

      Not checked in the free run.

    • cites [4] Karpansalo M, Kauhanen J, Lakka TA, Manninen P, Kaplan GA, Salonen JT (2005) Depression and early retirement: prospective population based study in middle aged men. J Epidemiol Community Health 59:70–74 source

      Not checked in the free run.

    • cites [5] Knudsen AK, Overland S, Aakvaag HF, Harvey SB, Hotopf M, Mykletun A (2010) Common mental disorders and disability pension award: seven year follow-up of the HUSK study. J Psychosom Res 69:59–67 source

      Not checked in the free run.

    • cites [6] Mykletun A, Heradstveit O, Eriksen K, Glozier N, Overland S, Maeland JG, Wilhelmsen I (2009) Health anxiety and disability pension award: the HUSK study. Psychosom Med 71:353–360 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    For some participants, personality disorder symptoms may have deteriorated during follow-up, and some had received a disability pension before the diagnostic interview.

    “For some, symptoms of PDs may have deteriorated in the follow-up period, and some participants had received a disability pension before their participation in the diagnostic interview.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The dependency among twins was corrected for using generalized estimating equations with an exchangeable covariance structure.

    “we corrected for the dependency using generalized estimating equations (GEE) with exchangeable covariance structure [27].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [27] Dobson AJ (2002) An introduction to generalized linear models. Chapman & Hall/CRC, USA

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The combination of antisocial and borderline loadings might explain why the antagonism/disinhibition component showed no significant association with disability pensioning.

    “This combination might explain why this component showed no significant association with disability pensioning.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Socioeconomic status was measured using parents' educational attainment rather than the participant's own because early disability pensioning may interfere with education and income.

    “We chose to measure SES based on the parents’ educational attainment rather than on the subject’s own, as disability pensioning early in life may interfere with education and income.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductreasoning

    A longer follow-up time would have been better for registering disability pensions as possible long-term consequences of personality disorders in this young adult sample.

    “In addition, with a young adult sample, a longer follow-up time would have been better for registering disability pensions as possible long-term consequences of PDs.”
    Quote in the paperNot a substantial claim
36 of 36

  • The authors state this as an assumption.

    Symptoms of personality disorders lead to disability pensioning rather than disability pensioning leading to personality disorder symptoms.

    “We therefore assume that symptoms of PD lead to disability pensioning, not the other way around.”
1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. OECD (2003) Disability programmes in need of reform—a policy brief. OECD Publishing, Paris
  2. Mykletun A, Knudsen AK (2009) Tapte arbeidsår ved uførepensjonering for psykiske lidelser. Norwegian institute of public health, Norway
  3. Akselsen A, Lien S, Sandnes T (2003) FD-trygd dokumentasjonsrapport. Pensjoner. Grunn og hjelpestønader 1992–2001. Rikstrygdeverket, Norway

Cited by

Sorted by citations

Related

Authors
Østby, K. A., Czajkowski, N., Knudsen, G. P., Ystrom, E., Gjerde, L. C., Kendler, K. S., Ørstavik, R. E., & Reichborn-Kjennerud, T.
Affiliations
  • Norwegian Institute of Public Health (NO)
  • Virginia Commonwealth University (US)
Corresponding author
Østby, Kristian Amundsen
ORCID
Venue
Social Psychiatry and Psychiatric Epidemiology
Publisher
Springer Science and Business Media LLC
Published
2014-05-03
Volume
49
Issue
12
Pages
2003-2011
ISSN
  • 0933-7954 (ISSN-L)
  • 1433-9285
DOI
10.1007/s00127-014-0878-0
PMC
PMC4218874
OpenAlex
W2079825557
Cited by
72
References
43
Citations by year
2026: 5 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 16 · 2021: 1 · 2020: 13 · 2019: 8 · 2018: 7 · 2017: 1 · 2016: 5 · 2015: 6 · 2014: 1
FWCI
5.11
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Norges Forskningsråd
  • National Institutes of Health
  • National Institute on Aging
  • National Institute of Mental Health (MH-068643, R01MH068643)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Demography › Retirement, Disability, and Employment
  • Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
Keywords
personality disorders, work disability, young adults, common mental disorders, mood disorders, anxiety disorders, schizoid personality disorder, dependent personality, borderline personality, antisocial personality, negative affectivity, psychoticism, detachment, personality traits
MeSH terms
Adult, Mental Disorders, Female, Persons with Disabilities, Humans, Interview, Psychological, Male, Norway, Pensions, Personality Disorders, Risk Factors, Odds Ratio, Diagnostic and Statistical Manual of Mental Disorders, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review