Jaana I Halonen1,2, Tarani Chandola3, Martin Hyde3, Taina Leinonen1, Hugo Westerlund2, Ville Aalto1, Jaana Pentti4,5, Mikko Laaksonen6, Sari Stenholm4, Minna Mänty5,7, Jussi Vahtera4, Tuula Oksanen1, Mika Kivimäki1,5,8, Marianna Virtanen2,9, Tea Lallukka1,5. 1. Finnish Institute of Occupational Health, Helsinki, Finland. 2. Stress Research Institute, Stockholm University, Stockholm, Sweden. 3. Centre for Innovative Ageing, Swansea University, Swansea, UK. 4. Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland. 5. Department of Public Health, University of Helsinki, Helsinki, Finland. 6. Research Department, Finnish Center for Pension, Helsinki, Finland. 7. Statistics and Research, City of Vantaa, Vantaa, Finland. 8. Department of Epidemiology and Public Health, University College London, UK. 9. School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
Abstract
BACKGROUND: Retirement has been associated with improved mental health, but it is unclear how much this is due to the removal of work-related stressors. We examined rates of psychotropic medication use before and after the transition to disability retirement due to mental, musculoskeletal and other causes by pre-retirement levels of perceived work stress (effort-reward imbalance, ERI). METHODS: Register-based date and diagnosis of disability retirement of 2766 participants of the Finnish Public Sector study cohort were linked to survey data on ERI, social- and health-related covariates, and to national records on prescribed reimbursed psychotropic medication, measured as defined daily doses (DDDs). Follow-up for DDDs was 2-5 years before and after disability retirement. We assessed differences in the levels of DDDs before and after retirement among those with high vs. low level of pre-retirement ERI with repeated measures regression. RESULTS: Those with high (vs. low) levels of ERI used slightly more psychotropic medication before disability retirement due to mental disorders [rate ratio (RR) 1.14, 95% confidence intervals (CI) 0.94-1.37], but after retirement this difference attenuated (RR 0.94, 95% CI 0.80-1.10, P for interaction 0.02). Such a change was not observed for the other causes of disability retirement. CONCLUSIONS: The level of psychotropic medication use over the transition to disability retirement due to mental, but not musculoskeletal or other, causes was modified by pre-retirement perceived work-related stress. This suggests that among people retiring due to mental disorders those who had stressful jobs benefit from retirement more than those with low levels of work-related stress.
BACKGROUND: Retirement has been associated with improved mental health, but it is unclear how much this is due to the removal of work-related stressors. We examined rates of psychotropic medication use before and after the transition to disability retirement due to mental, musculoskeletal and other causes by pre-retirement levels of perceived work stress (effort-reward imbalance, ERI). METHODS: Register-based date and diagnosis of disability retirement of 2766 participants of the Finnish Public Sector study cohort were linked to survey data on ERI, social- and health-related covariates, and to national records on prescribed reimbursed psychotropic medication, measured as defined daily doses (DDDs). Follow-up for DDDs was 2-5 years before and after disability retirement. We assessed differences in the levels of DDDs before and after retirement among those with high vs. low level of pre-retirement ERI with repeated measures regression. RESULTS: Those with high (vs. low) levels of ERI used slightly more psychotropic medication before disability retirement due to mental disorders [rate ratio (RR) 1.14, 95% confidence intervals (CI) 0.94-1.37], but after retirement this difference attenuated (RR 0.94, 95% CI 0.80-1.10, P for interaction 0.02). Such a change was not observed for the other causes of disability retirement. CONCLUSIONS: The level of psychotropic medication use over the transition to disability retirement due to mental, but not musculoskeletal or other, causes was modified by pre-retirement perceived work-related stress. This suggests that among people retiring due to mental disorders those who had stressful jobs benefit from retirement more than those with low levels of work-related stress.
Authors: Mikko Laaksonen; Marko Elovainio; Sakari Kainulainen; Taina Leinonen; Tuija Jääskeläinen; Harri Rissanen; Seppo Koskinen Journal: Eur J Public Health Date: 2022-10-03 Impact factor: 4.424