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A Population-Based Cohort Study of the Effect of Common Mental Disorders on Disability Pension Awards
Abstract
OBJECTIVE: Mental illness is consistently underrecognized in general health care, which may lead to underestimation of its effects on awards for social security payments. The authors investigated empirically the contribution of psychiatric morbidity to the award of disability pensions, in particular those awarded for physical diagnoses. METHOD: Using a historical cohort design, the authors utilized a unique link between a large epidemiological cohort study and a comprehensive national database. Baseline information on mental and physical health was gathered from a 1995-1997 population-based health study of those of working age (20-66 years) in Nord-Trøndelag County, Norway, who were not recipients of disability pension (N=45,782). The outcome assessed was the awarding of disability pensions ascribed to specific ICD-10 diagnoses within 6 to 30 months as registered in the National Insurance Administration. RESULTS: Anxiety and depression were robust predictors of disability pension awards in general, even when disability pensions awarded for any mental disorder were excluded. These effects were only partly explained by baseline somatic symptoms and diagnoses and were stronger in individuals aged 20-44 than in those aged 45-66. Somatic symptoms accounted for far more disability pension awards than did somatic diagnoses. CONCLUSIONS: The cost of common mental disorders in terms of disability pensions and lost productivity may have been considerably underestimated by official statistics, particularly for younger claimants. The results suggest this might be due both to overuse of physical diagnoses and underrecognition of common mental disorders in primary care.
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“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].”
From Personality disorders are important risk factors for disability pensioning (2014) · cites this paper as [8]
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BackgroundSelf-citation
Metadata
- Authors
- Mykletun, A.
- Affiliations
- University of Bergen (NO)
- ORCID
- Mykletun, Arnstein
- Venue
- American Journal of Psychiatry
- Published
- 2006-08-01
- Volume
- 163
- Issue
- 8
- Pages
- 1412
- ISSN
- 0002-953X (ISSN-L)
- OpenAlex
- W1990528257
- Cited by
- 237
- References
- 217
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 8 · 2020: 8 · 2019: 9 · 2018: 10 · 2017: 15 · 2016: 14 · 2015: 14 · 2014: 19 · 2013: 18 · 2012: 20
- FWCI
- 49.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Demography › Retirement, Disability, and Employment
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Keywords
- common mental disorders, disability pension, anxiety, depression, somatic symptoms, social security benefits, working-age adults, primary care
- MeSH terms
- Adult, Age Factors, Aged, Anxiety Disorders, Mental Disorders, Depressive Disorder, Disability Evaluation, Humans, Male, Middle Aged, Norway, Pensions, Sex Factors, Social Security, Social Welfare, Cohort Studies, Comorbidity, Confidence Intervals, Odds Ratio
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