Predictors of long-term work disability in Major Depressive Disorder: a prospective study

• Published in: Acta Psychiatrica Scandinavica Vol. 115; no. 3; pp. 206 - 213
• Main Authors: Rytsälä, H. J., Melartin, T. K., Leskelä, U. S., Sokero, T. P., Lestelä-Mielonen, P. S., Isometsä, E. T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2007; Blackwell
• Subjects: Adult; Adult and adolescent clinical studies; Biological and medical sciences; Demography; Depression; depressive disorder; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Disability; Disability Evaluation; Female; Finland - epidemiology; Follow-Up Studies; Humans; insurance; major; Male; Medical sciences; Mental depression; Mental disorders; Middle Aged; Mood disorders; Pensions; Pensions - statistics & numerical data; Prospective Studies; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sick leave; Studies; Time Factors; work; Finland; Mood disorder; insurance; major; Follow up study; disability; Work; depressive disorder; Depression; Predictive factor; Long term; Work disability; sick leave
• ISSN: 0001-690X; 1600-0447; 0065-1591
• DOI: 10.1111/j.1600-0447.2006.00878.x

Objective:  Major Depressive Disorder (MDD) is a major cause of long‐term work disability. However, factors predicting this are not well known. Method:  In the Vantaa Depression Study, predictors for being granted a disability pension during an 18‐month follow‐up were examined among the 186 psychiatric MDD in‐ and out‐patients belonging to the labour force at baseline. Results:  The 21 patients (11.3%) granted a disability pension were significantly older, more hopeless, had worse social and occupational functioning, and spent more time depressed during follow‐up. After adjusting for these predictors, being on sick leave at baseline still strongly predicted disability pension during follow‐up. Conclusion:  Disability pension is predicted by multiple sociodemographic and clinical factors. Baseline level of functioning and duration of depressive episodes are key clinical predictors. The positive and negative consequences of sick leave warrant closer attention.