Long-term disability in common mental disorders in Chinese community: evidence from a five-year follow-up study

BACKGROUND

Common mental disorders are general term for mental disorders with high disability rates and significant social burden. The purpose of this study was to determine the degree of long-term disability associated with common mental disorders and to interpret the relationship between common mental disorders and long-term disability.

METHODS

Participants in the 2013 China Mental Health Survey were followed up by telephone between April and June 2018. This study evaluated long-term disability over a five-year period using the World Health Organization's Disability Assessment Schedule 2.0. Poisson regression was used to analyze the relationship between common mental disorders and long-term disability.

RESULTS

A total of 6269 patients were followed up by telephone. In patients with common mental disorders, the prevalence of disability ranged from 7.62% to 43.94%. The long-term disabilities were significantly associated with dysthymic disorder (DD, RR:2.40; 95% CI:1.87-3.03), major depressive disorder (MDD, RR:1.63; 95% CI:1.34-1.98), generalized anxiety disorder (GAD, RR:1.95; 95% CI:1.15-3.09), obsessive-compulsive disorder (OCD, RR:1.68; 95% CI:1.24-2.22) and alcohol use disorder (AUD, RR: 1.42; 95% CI:0.99-1.96).

CONCLUSIONS

In China, common mental disorders raise the risk of long-term disability, and there is a critical need for monitoring patients with DD, MDD, GAD, OCD, and AUD. For improved quality of life and reduced disability levels, more resources need to be dedicated to mental health in the future.

Intraindividual association between shift work and risk of drinking problems: data from the Finnish Public Sector Cohort

OBJECTIVES

Studies concerning the association between shift work and drinking problems showed inconsistent results. We used data from a large occupational cohort to examine the association between shift work and different types of drinking behaviour.

METHODS

A total of 93 121 non-abstinent workers from the Finnish Public Sector Study were enrolled in the study. Six waves of survey data were collected between 2000 and 2017. Work schedules were categorised as regular day, non-night shift and night shift work, and shift intensities were calculated from registered working hour data. Two indicators of adverse drinking behaviour were measured: at-risk drinking (>7 and >14 drinks per week in women and men, respectively) and high-intensity drinking (measured as pass-out experience). Intraindividual analysis was conducted using fixed-effects regression to examine the association between shift work and drinking behaviours.

RESULTS

Compared with regular day work, night shift work was associated with an increased risk of high-intensity drinking (OR 1.28, 95% CI 1.07 to 1.52) but a lower risk of at-risk drinking (OR 0.85, 95% CI 0.74 to 0.99). Shift workers who worked long shifts had a lower risk of at-risk drinking compared with those who rarely worked long shifts (OR 0.58, 95% CI 0.37 to 0.93).

CONCLUSIONS

Associations between shift work and alcohol use vary according to drinking patterns. Workers engaged in high-intensity drinking more often during night shift schedules compared with day work, but did not drink averagely higher volume.

Alcohol consumption and labour market participation: a prospective cohort study of transitions between work, unemployment, sickness absence, and social benefits

The aim of this study was to investigate the association of alcohol consumption and problem drinking on transitions between work, unemployment, sickness absence and social benefits. Participants were 86,417 men and women aged 18-60 years who participated in the Danish National Health Survey in 2010. Information on alcohol consumption (units per week) and problem drinking (CAGE-C score of 4-6) was obtained by questionnaire. The primary outcome was labour market attachment. Information on labour market attachment was obtained from the national administrative registers during a 5-year follow-up period. Using Cox proportional hazards models, we estimated hazard ratios (HR) for transitions between work, unemployment, sickness absence and social benefits. Analyses were adjusted for potential confounders associated with demography, health, and socio-economy. High alcohol consumption and problem drinking was associated with higher probability of unemployment, sickness absence and social benefits among participants employed at baseline compared with participants who consumed 1-6 drinks/week. High alcohol consumption and problem drinking was associated with lower probability of returning to work among participants receiving sickness absence at baseline compared with participants who consumed 1-6 drinks/week and with non-problem drinkers: HRs were 0.75 (0.58-0.98) for 35+ drinks per week and 0.81 (0.65-1.00) for problem drinking (CAGE-C score of 4-6). Similar trends for weekly alcohol consumption and problem drinking were observed among participants who were unemployed at baseline. In summary, problem drinking has adverse consequences for labour market participation and is associated with higher probability of losing a job and a lower chance of becoming employed again.

Alcohol use and sickness absence due to all causes and mental- or musculoskeletal disorders: a nationally representative study

Background

Previous studies have not distinguished between different alcohol-use histories, which could have contributed to the current inconsistent evidence regarding the relationship between alcohol use and subsequent sickness absence. We thus examined alcohol use and subsequent diagnosis-specific sickness absence in groups with different levels of alcohol use, as well as in lifelong abstainers, former drinkers, and people with clinical alcohol use disorders.

Methods

The data of the population-based Health 2000 Survey (BRIF8901) of 3666 Finns aged 30–55 were linked with national registers on medically certified sickness absences lasting for > 10 working days (long-term) for all causes (2000 − 2010) and for mental or musculoskeletal disorders (2004-2010), as well as with registers on pensions and death (2000-2010). Alcohol use was assessed by questionnaire. Chronic somatic diseases were evaluated at baseline in a clinical examination, and common mental and alcohol use disorders using the Composite International Diagnostic Interview (CIDI). Cox regression analyses were conducted with censoring for death and retirement from work.

Results

During an average 10-year follow-up, 56.0% of the participants had at least one long-term sickness absence period. Compared with light drinkers, those having an alcohol use disorder had increased risk of all-cause sickness absence (HR = 1.27; 95% CI = 1.04 − 1.54) and sickness absence due to mental disorders (HR = 2.16; 95% CI = 1.39 − 3.35), when somatic and mental disorders as well as demographic, lifestyle-related and occupational factors at baseline were accounted for. Lifelong abstainers did not differ from light drinkers. Also high-volume drinking (HR = 1.52; 95% CI 1.03 − 2.25) and former drinking (HR = 1.57; 95% CI = 1.15 − 2.15) were associated with long-term sickness absence due to mental disorders. Alcohol use was not predictive of sickness absence due to musculoskeletal disorders.

Conclusions

These results highlight the need to distinguish between former drinking and lifelong abstinence, as only former drinking was associated with sickness absence. Alcohol use disorder and high-volume drinking were strongly predictive of sickness absence due to mental disorders. Identifying people with excessive alcohol use e.g. in occupational health care, and mapping and supporting their mental health may help in preventing sickness absences.

Health, lifestyle and employment beyond state-pension age

Background

The factors influencing one’s choice to retire vary, with financial and health considerations being some of the main factors impacting or associated with people’s timing of retirement. The aim of the study is to investigate the differences in current health and health-related behaviours, such as smoking, drinking and exercising, between people who kept on working beyond state-pension age and those who retired before or at state-pension age.

Methods

Data from six waves (2003, 2008–2012) of the Scottish Health Survey (SHeS) are used. Descriptive analyses were used to characterise the population. Multivariate logistic regression was undertaken to analyse the relationship between retirement groups and gender, age, deprivation, marital status, housing tenure, general health, longstanding illness, cigarette smoking status, amount of exercise and mental health, using Stata.

Results

Reporting poor self-rated health or having a long-standing illness was associated with increased odds of retiring before state pension age (SPA) in groups with a medium deprivation profile in almost all the survey years. For the least deprived there was little evidence of an association between poor health and extended-working-life, while significant associations were observed for the most deprived. An increasing trend was observed for both genders in the number of people extending their working life. Similar associations between reporting poorer self-rated health and extended working lives were observed for men and women. Distinct gender differences were observed for the associations with reporting poor mental health and no exercise. In the adjusted models, both were significantly associated with retiring at or before SPA in almost every year for women, whereas no significant associations were observed (except in 1 year) for men.

Conclusions

This study shows an increasing trend in the number of people extending their working lives and demonstrates significant associations between health and lifestyle behaviours and employment status past SPA. The results suggest that good health – both physically and mentally – along with either a need or a want to stay in employment could be important reasons for continuing to work beyond SPA.

Electronic supplementary material

The online version of this article (10.1186/s12889-017-4957-5) contains supplementary material, which is available to authorized users.

Alcohol consumption and risk of unemployment, sickness absence and disability pension in Denmark: a prospective cohort study

AIMS

We investigated the association between weekly alcohol consumption and binge drinking and the risk of unemployment, sickness absence and disability pension.

DESIGN

Prospective register-based cohort study.

SETTING

Denmark.

PARTICIPANTS

A sample of 17 690 men and women, aged 18-60 years from the Danish Health and Morbidity Survey in 2000, 2005 and 2010 participated in the study. Participants worked the entire year prior to baseline.

MEASUREMENTS

Administrative registers were used to obtain information on unemployment, sickness absence and disability pension during a 5-year follow-up period. Data were analysed by multivariate Cox regression model with random effect (frailty) adjusted for cohabitation status, educational level, Charlson comorbidity index, smoking habits, calendar year and geographic region.

FINDINGS

Among males, adjusted hazards ratios (HR) of unemployment were 1.24 (95% CI 1.05-1.46, P = 0.01), 1.28 (95% CI 1.04-1.59, P =0.02) and 1.48 (95% CI 1.21-1.81, P = 0.00) respectively, for abstainers and those with alcohol consumption of 21-27 and ≥ 28 drinks per week when compared with individuals who had 1-13 drinks per week. Corresponding HRs for sickness absence were 1.16 (95% CI 1.02-1.33, P = 0.03), 1.02 (95% CI 0.85-1.23, P = 0.84), and 1.23 (95 % CI 1.04-1.46, P = 0.02). Male abstainers had increased HR for subsequently receiving disability pension. Female abstainers had increased HR of unemployment, sickness absence and disability pension compared to women with moderate alcohol consumption. Binge drinking was associated with higher HR of unemployment compared to non-binge drinking in women: HR of 1.21 (95 % CI 1.03-1.41, P = 0.02).

CONCLUSIONS

In Danish men aged 18-60, alcohol abstinence and heavy consumption is associated with increased subsequent risk of unemployment and sickness absence compared with low consumption. In Danish women abstainers have increased risk of unemployment, sickness absence and disability pension, while binge drinkers are more likely to become unemployed subsequently.

The association between alcohol drinking and self-reported mental and physical functioning: a prospective cohort study among City of Helsinki employees

OBJECTIVES

Alcohol drinking is associated with ill health but less is known about its contribution to overall functioning. We aimed to examine whether alcohol drinking predicts self-reported mental and physical functioning 5-7 years later.

DESIGN

A prospective cohort study.

SETTING

Helsinki, Finland.

PARTICIPANTS

40-year-old to 60-year-old employees of the City of Helsinki (5301 women and 1230 men) who participated in a postal survey in 2000-2002 and a follow-up survey in 2007.

PRIMARY AND SECONDARY OUTCOME MEASURES

Mental and physical functioning measured by the Short Form 36 Health Survey.

RESULTS

Alcohol drinking was differently associated with mental and physical functioning. Heavy average drinking, binge drinking and problem drinking were all associated with subsequent poor mental functioning except for heavy average drinking among men, whereas only problem drinking was associated with poor physical functioning. Also, non-drinking was associated with poor physical functioning. Problem drinking was the drinking habit showing most widespread and strongest associations with health functioning. The associations between problem drinking and poor mental functioning and with poor physical functioning among women remained after adjusting for baseline mental functioning, sociodemographic factors, working conditions and other health behaviours.

CONCLUSIONS

Alcohol drinking is associated especially with poor mental functioning. Problem drinking was the drinking habit strongest associated with poor health functioning. The results call for early recognition and prevention of alcohol problems in order to improve health functioning among employees.

Association between midlife health behaviours and transitions out of employment from midlife to early old age: Whitehall II cohort study

Background

It is important to determine whether unhealthy behaviours might influence transitions out of employment from midlife to old age, given the anticipated need for adults to work for longer. Our aim was to determine the association between repeated assessments of cigarette smoking, heavy/problem alcohol drinking, low physical activity and poor diet at midlife, in relation to work exit from midlife to old age.

Methods

Data from 7704 participants (5392 men) from the Whitehall II cohort study in employment at midlife were used to evaluate the association between unhealthy behaviours and a subsequent transition out of work during 22 years follow-up, using logistic regression models.

Results

Men who smoked cigarettes, consistently drank alcohol heavily, or reported problem drinking, were more likely to leave employment over follow-up. Women with a consistently poor diet were more likely to leave employment. Associations were stronger when the reason for leaving was health grounds, and stronger among those with persistently unhealthy behaviours over follow-up. The size of the effects were broadly equivalent to one advancing year of age on employment. Physical health functioning over follow-up only partly accounted for the associations with work exit, whereas physical and mental functioning accounted for most of the associations with work exit on health grounds.

Conclusions

Unhealthy behaviours in midlife are associated with transitions out of employment into old age. Promoting healthy behaviours at midlife might support current policy initiatives aimed at extending working life. Future research should consider possible mechanisms that link behaviours to transitions out of employment, and consider sex differences in larger cohorts.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3970-4) contains supplementary material, which is available to authorized users.