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Widespread pain and medically certified disability pension in the H ordaland H ealth S tudy
Author(s) -
Øverland S.,
Harvey S.B.,
Knudsen A.K.,
Mykletun A.,
Hotopf M.
Publication year - 2012
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 - 10.1016/j.ejpain.2011.08.005
Subject(s) - certification , medicine , gerontology , economics , management
Abstract Widespread pain ( WSP ) is common in the general population and is associated with poor outcomes. The aim of this study was to quantify the risk for medically certified disability pension from WSP . We further studied how other common physical symptoms, common mental disorders and functional limitations influenced this risk. A prospective cohort design was established by linking the large population based H ordaland H ealth S tudy ( n > 18000 individuals aged 40–46) with an administrative registry on disability pension awards. We modelled hazard ratios for later all‐cause and diagnosis specific disability pensioning from WSP , adjusted for potential confounders and examined the impact of other co‐occurring health problems and functional limitations. WSP was common (12.4%) and associated with a range of mental health, and non‐specific and non‐musculoskeletal symptoms. As expected, WSP was a strong predictor for disability pension award. Hazard ratios ( HR ) adjusted for socio‐economic status, health behaviours and comorbid medical diagnoses indicated WSP was strongest in predicting pensioning for musculoskeletal diagnoses ( HR = 5.91, 95% CI 4.64–7.54), but also predicted pensioning for mental disorder ( HR = 3.13, 95% CI 2.20–4.46) and other diagnoses ( HR = 1.81, 95% CI 1.30–2.51). Further adjustments for other common symptoms, including mental illness, reduced, but did not abolish these risks. WSP is a major risk factor for disability pensions, and not only pensions for musculoskeletal disorders. The global impact of WSP , and its close association to other symptoms, suggests prevention of the severe occupational outcomes for this group must have a broad focus and move beyond symptom directed approaches.