Matti Joensuu1, Pauliina Mattila-Holappa2, Kirsi Ahola2, Jenni Ervasti2, Mika Kivimäki2,3,4, Teija Kivekäs2, Aki Koskinen2, Jussi Vahtera2,5, Marianna Virtanen2. 1. Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland. matti.joensuu@ttl.fi. 2. Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland. 3. Clinicum, University of Helsinki, Helsinki, Finland. 4. Department of Epidemiology and Public Health, University College London, London, UK. 5. Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
Abstract
PURPOSE: Mental disorders are the leading cause of work disability among young adults. This study examined whether distinct classes could be identified among young adults on the basis of medical history before receiving a disability pension due to a mental disorder. METHODS: Medical history was obtained from pension applications and attached medical certificates for 1163 individuals aged 18-34 years who, in 2008, received a disability pension due to a mental disorder. Using latent class analysis, 10 clinical and individual adversities and their associations with sex, age and diagnostic category were examined. RESULTS: Three classes were identified: childhood adversity (prevalence, 33%), comorbidity (23%), and undefined (44%). The childhood adversity class was characterized by adverse events and symptoms reported during childhood and it associated with depressive disorders. The comorbidity class was characterized by comorbid mental disorders, suicide attempts and substance abuse and associated with younger age and bipolar disorder. The undefined class formed no distinct profile; individuals in this class had the lowest number of adversities and it associated with psychotic disorders. CONCLUSIONS: The identification of subgroups characterized by childhood circumstances and comorbidity may help planning of prevention and support practices for young adults with mental disorders and risk of work disability.
PURPOSE: Mental disorders are the leading cause of work disability among young adults. This study examined whether distinct classes could be identified among young adults on the basis of medical history before receiving a disability pension due to a mental disorder. METHODS: Medical history was obtained from pension applications and attached medical certificates for 1163 individuals aged 18-34 years who, in 2008, received a disability pension due to a mental disorder. Using latent class analysis, 10 clinical and individual adversities and their associations with sex, age and diagnostic category were examined. RESULTS: Three classes were identified: childhood adversity (prevalence, 33%), comorbidity (23%), and undefined (44%). The childhood adversity class was characterized by adverse events and symptoms reported during childhood and it associated with depressive disorders. The comorbidity class was characterized by comorbid mental disorders, suicide attempts and substance abuse and associated with younger age and bipolar disorder. The undefined class formed no distinct profile; individuals in this class had the lowest number of adversities and it associated with psychotic disorders. CONCLUSIONS: The identification of subgroups characterized by childhood circumstances and comorbidity may help planning of prevention and support practices for young adults with mental disorders and risk of work disability.
Entities:
Keywords:
Disability; Employment; Insurance; Risk factors; Work
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