BACKGROUND: Between 1990 and 2000, the number of disability benefit recipients in Norway increased by 19.3%. We wanted to examine changes in the way people cope with society's demands, our hypothesis being that changing demands increase psychological stress; this again leads to increasing numbers of disability benefit recipients with a psychiatric diagnosis. MATERIAL AND METHODS: We examined the ability to support oneself financially among the 20 to 39-year-olds, traditionally the period in people's lives when they are at their most adaptive. We used data for the 1990-2000 period on sickness absence of one year or more, medical or occupational rehabilitation, long-term unemployment, welfare payments without entitlement, and disability benefits. We examined the diagnoses used for one-year sickness absence, medical rehabilitation and disability benefit status. Data were obtained from the relevant public-sector registers. RESULTS: The prevalence of social security clients in the 20-39 age group was up from 6.4% in 1994 to 7.7% in 2000, an increase of 20%. The biggest increases (1992 to 2000 data) were related to minor psychiatric disorders, 152%, and milder forms of musculoskeletal disorders, 111%. INTERPRETATION: Changing demands in the workplace have increased the load of psychological stress in society, but changing demands in people's private lives are a contributing factor. The results imply an increasing mismatch between the adaptation required in our society and people's resources for coping with what is expected of them. Our health care and social security systems in their present form cannot properly come to grips with this situation; they may even exacerbate it by demanding too little of patients and thereby socialising them into the patient role.
BACKGROUND: Between 1990 and 2000, the number of disability benefit recipients in Norway increased by 19.3%. We wanted to examine changes in the way people cope with society's demands, our hypothesis being that changing demands increase psychological stress; this again leads to increasing numbers of disability benefit recipients with a psychiatric diagnosis. MATERIAL AND METHODS: We examined the ability to support oneself financially among the 20 to 39-year-olds, traditionally the period in people's lives when they are at their most adaptive. We used data for the 1990-2000 period on sickness absence of one year or more, medical or occupational rehabilitation, long-term unemployment, welfare payments without entitlement, and disability benefits. We examined the diagnoses used for one-year sickness absence, medical rehabilitation and disability benefit status. Data were obtained from the relevant public-sector registers. RESULTS: The prevalence of social security clients in the 20-39 age group was up from 6.4% in 1994 to 7.7% in 2000, an increase of 20%. The biggest increases (1992 to 2000 data) were related to minor psychiatric disorders, 152%, and milder forms of musculoskeletal disorders, 111%. INTERPRETATION: Changing demands in the workplace have increased the load of psychological stress in society, but changing demands in people's private lives are a contributing factor. The results imply an increasing mismatch between the adaptation required in our society and people's resources for coping with what is expected of them. Our health care and social security systems in their present form cannot properly come to grips with this situation; they may even exacerbate it by demanding too little of patients and thereby socialising them into the patient role.