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Excess mortality after disability retirement due to mental disorders: variations by socio-demographic factors and causes of death

  • Taina LeinonenEmail author
  • Pekka Martikainen
  • Mikko Laaksonen
  • Eero Lahelma
Original Paper

Abstract

Purpose

Mental disorders are the key causes of disability retirement and are associated with a high risk of mortality. Social variations in excess mortality after disability retirement are nevertheless poorly understood. We examined socio-demographic differences in all-cause and cause-specific mortality after disability retirement due to depression and other mental disorders.

Methods

The data comprised a nationally representative sample of the Finnish population aged 25–64 in 1996 with no prior disability retirement due to mental disorders (N = 392,985). We used Cox regression analysis with disability retirement due to mental disorders as a time-varying covariate and mortality between 1997 and 2007 as the outcome variable.

Results

We found excess mortality after disability retirement due to mental disorders as compared to those with no such retirement in all specific causes of death, in particular alcohol-related causes, suicide, and other unnatural causes. Excess suicide mortality was particularly large after depression-based disability retirement. Younger age groups, non-manual classes, and those living with a partner and children had largest excess mortality, especially from unnatural and alcohol-related causes. However, the absolute number of excess deaths was not always largest in these socio-demographic groups.

Conclusions

In young adulthood, disability retirement due to depression signifies severe health and other social disadvantages that lead to particularly large excess mortality, especially due to unnatural causes. The protective effects of a high socioeconomic position and family ties against unnatural and alcohol-related deaths are limited among those who have already developed depression or other mental disorders that have led to disability retirement.

Keywords

Disability retirement Mental disorders Depression Mortality Cause of death Socio-demographic factors 

Notes

Acknowledgement

We are grateful to Statistics Finland, the Finnish Centre for Pensions, and the Social Insurance Institution of Finland for making the data available to us. This study was supported by the Finnish Doctoral Program in Social Sciences, the Emil Aaltonen Foundation, and the Academy of Finland.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

127_2013_747_MOESM1_ESM.docx (20 kb)
Supplementary material (DOCX 20 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Taina Leinonen
    • 1
    Email author
  • Pekka Martikainen
    • 1
  • Mikko Laaksonen
    • 2
  • Eero Lahelma
    • 3
  1. 1.Population Research Unit, Department of Social ResearchUniversity of HelsinkiHelsinkiFinland
  2. 2.Finnish Centre for PensionsHelsinkiFinland
  3. 3.Department of Public Health, Hjelt InstituteUniversity of HelsinkiHelsinkiFinland

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