Return to Work or Not: The Paths to Psychiatric Disability and Back.

IF 2.5 3区 医学 Q1 REHABILITATION
Päivi Rissanen, Sami Pirkola, Turkka Näppilä, Tino Karolaakso, Helena Leppänen, Sari Fröjd, Reija Autio
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Abstract

Objectives: Mental health-related work disability has increased in Europe, despite efforts to promote individuals´ work ability. We examined individuals´ occupational status before and after a psychiatric disability pension (DP).

Methods: The study comprises individuals granted a DP for the first time between 2010 and 2012 in Finland (N = 18,373). We used modern methods to cluster the sequences of individuals´ occupational status before and after temporary (n = 8615) or permanent (n = 9758) psychiatric DP. We compared socioeconomic, illness and health care system-related factors between nine groups, formed by sequence analysis utilizing multinominal regression analysis.

Results: The analysis identified typical groups of temporary pensioners: after steady working careers, periods of unemployment and from mixed states. Severity of health and mental health problems, socioeconomic and occupational status, pension system-related factors as well as treatment or rehabilitation varied between the groups. Individuals with temporary DPs (tDP) appeared mainly to either remain disabled (74% of the study tDP) or return to the same status they had before disability: to work (17%) or unemployment (8%). A steady working career, high education and received psychotherapy and rehabilitation all promoted returning to work. Among young adults, severity of the illness and lack of occupational education were risk factors for long-term disability.

Conclusions: Among those with tDP, circles of disadvantage may exist. They relate to unemployment, poor mental and somatic heath, low education, poverty, and failure of rehabilitative efforts. Especially young adults with severe mental disorders require not only rehabilitation but also educational support.

是否重返工作岗位:通往精神残疾和回归的道路。
目标:在欧洲,尽管努力提高个人的工作能力,但与精神健康有关的工作残疾有所增加。我们检查了个体在精神残疾抚恤金(DP)之前和之后的职业状况。方法:该研究包括芬兰2010年至2012年间首次获得DP的个体(N = 18,373)。我们使用现代方法对临时(n = 8615)或永久(n = 9758)精神疾病治疗前后的个体职业状况序列进行聚类。我们比较了九个组之间的社会经济、疾病和卫生保健系统相关因素,通过使用多项回归分析的序列分析形成。结果:分析确定了临时养老金领取者的典型群体:在稳定的工作生涯之后,失业时期和来自混合州。健康和精神健康问题的严重程度、社会经济和职业状况、养老金制度相关因素以及治疗或康复在不同群体之间有所不同。临时伤残人士(tDP)主要表现为要么继续残疾(74%的研究tDP),要么恢复到残疾前的状态:工作(17%)或失业(8%)。稳定的工作、受过高等教育、接受过心理治疗和康复治疗都有助于重返工作岗位。在年轻人中,疾病的严重程度和缺乏职业教育是导致长期残疾的危险因素。结论:在tDP患者中可能存在不利圈。它们与失业、精神和身体健康状况不佳、教育程度低、贫困和康复努力失败有关。尤其是患有严重精神障碍的年轻人,不仅需要康复,还需要教育支持。
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来源期刊
CiteScore
5.80
自引率
12.10%
发文量
64
期刊介绍: The Journal of Occupational Rehabilitation is an international forum for the publication of peer-reviewed original papers on the rehabilitation, reintegration, and prevention of disability in workers. The journal offers investigations involving original data collection and research synthesis (i.e., scoping reviews, systematic reviews, and meta-analyses). Papers derive from a broad array of fields including rehabilitation medicine, physical and occupational therapy, health psychology and psychiatry, orthopedics, oncology, occupational and insurance medicine, neurology, social work, ergonomics, biomedical engineering, health economics, rehabilitation engineering, business administration and management, and law.  A single interdisciplinary source for information on work disability rehabilitation, the Journal of Occupational Rehabilitation helps to advance the scientific understanding, management, and prevention of work disability.
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