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Early retirement in cancer patients with or without comorbid mental health conditions: A prospective cohort study
Author(s) -
Singer Susanne,
Meyer Alexandra,
Wienholz Sabine,
Briest Susanne,
Brown Anna,
Dietz Andreas,
Binder Harald,
Jonas Sven,
Papsdorf Kirsten,
Stolzenburg JensUwe,
Köhler Uwe,
Raßler Jörg,
Zwerenz Rüdiger,
Schröter Katharina,
Mehnert Anja,
Löbner Margrit,
König HansHelmut,
RiedelHeller Steffi G.
Publication year - 2014
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.28716
Subject(s) - medicine , health and retirement study , depression (economics) , relative risk , confidence interval , poisson regression , anxiety , incidence (geometry) , rate ratio , demography , prospective cohort study , cohort , cohort study , psychiatry , gerontology , population , physics , environmental health , sociology , optics , economics , macroeconomics
BACKGROUND The authors investigated whether cancer patients who have comorbid mental health disorders (MD) are at greater risk of early retirement compared with those who do not have MD. METHODS Individuals ages 18 to 55 years from a consecutive sample of patients who were admitted for inpatient oncologic treatment were interviewed using structured clinical interviews to ascertain MD. The patients were followed for 15 months, and the date of early retirement was documented. Rates of early retirement per 100 person‐years (py) in patients with and without MD were compared using multivariate Poisson regression models. RESULTS At baseline, 491 patients were interviewed, and 150 of those patients (30.6%) were diagnosed with MD. Forty‐one patients began full early retirement during follow‐up. In patients with MD, the incidence of early retirement was 9.3 per 100 py compared with 6.1 per 100 py in mentally healthy patients. The crude rate ratio (RR) was 1.5 (95% confidence interval [CI], 0.8‐2.8). The effect of MD on early retirement was modified in part by income: in patients with low income, the adjusted RR was 11.7, whereas no effect was observed in higher income groups. Patients with depression were at greater risk of retirement when they had higher income (RR, 3.4; P = .05). The effects of anxiety (RR, 2.4; P = .05), adjustment disorders (RR, 1.7; P = .21), and alcohol dependence (RR, 1.8; P = .40) on early retirement were equal across income groups. CONCLUSIONS Mental health conditions are risk factors for early retirement in cancer patients, although this effect differs according to the type of disorder and the patient's income level. Cancer 2014;120:2199–2206 . © 2014 American Cancer Society .