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Sickness absence due to back pain or depressive episode and the risk of all‐cause and diagnosis‐specific disability pension: A Swedish cohort study of 4,823,069 individuals
Author(s) -
Dorner T.E.,
Alexanderson K.,
Svedberg P.,
Ropponen A.,
Stein K.V.,
MittendorferRutz E.
Publication year - 2015
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.661
Subject(s) - disability pension , medicine , comorbidity , sick leave , proportional hazards model , hazard ratio , multivariate analysis , population , cohort , psychiatry , physical therapy , confidence interval , environmental health
Background The aim of this study was to investigate the associations between sickness absence due to back pain or depressive episode with future all‐cause and diagnosis‐specific disability pension, while adjusting for comorbidity and socio‐demographics, for all and stratifying for sex. Method In total, 4,823,069 individuals aged 16–64 years, living in Sweden at the end of 2004, not on old‐age or disability pension in 2005 and without ongoing sickness absence at the turn of 2004/2005 formed the study population. Crude and adjusted hazard ratios ( HR s) for all‐cause and diagnosis‐specific disability pension (2006–2010) in relation to diagnosis‐specific sickness absence with sickness benefits paid by the Social Insurance Agency were estimated using Cox regression. Results The HR for all‐cause disability pension was 7.52 (7.25–7.52) in individuals with an incident sick‐leave spell due to back pain, compared to individuals without sickness absence in 2005 in the fully adjusted (socio‐demographics and comorbidity) model. The fully adjusted (multivariate) HR s for diagnosis‐specific disability pension were musculoskeletal diagnoses 23.87 (22.75–25.04), mental 2.49 (2.27–2.73) or all other diagnoses, 3.44 (3.17–3.75). In individuals with an incident sick‐leave spell due to a depressive episode in 2005, the multivariate adjusted HR for all‐cause disability pension was 12.87 (12.42–13.35), while the multivariate HR s for disability pension due to musculoskeletal diagnoses were 4.39 (3.89–4.96), for mental diagnoses 25.32 (24.29–26.38) and for all other somatic diagnoses 3.44 (3.09–3.82). Men who were sickness absent due to a depressive episode had a higher HR for disability pension compared to women. Conclusion Results indicate that sickness absence due to a depressive episode or back pain is a strong risk factor for a future disability pension due to mental, musculoskeletal or other somatic diagnoses.