title: Five-year follow-up study of disability pension rates in first-onset schizophrenia with special focus on regional differences and mortality.
abstract: OBJECTIVE
  To evaluate the rate and regional determinants of disability pension in first-admission schizophrenia. In addition, we investigated whether patients with disability pension had increased mortality rates during follow-up.
  
  
  METHODS
  A nationwide register-based 5-year follow-up study of all patients with onset of schizophrenia between 1998 and 2001 (n=3,875).
  
  
  RESULTS
  A total of 1944 (50.2%) first-onset schizophrenia patients retired on disability pension during the 5-year follow-up. Males retired on pension at an earlier age and more often than females. Regional disability pension rates and retirement times for schizophrenia varied between hospital districts. Patients on disability pension had lower overall and suicide mortality, and they had less physical illness, depression and more psychotropic medication use than patients without disability pension. In regions with a short median time from onset time to retirement, there was significantly higher regional overall mortality and suicide mortality. Disability pension rates were also higher in regions with high involuntary treatment rate.
  
  
  CONCLUSIONS
  Half of the schizophrenia patients were pensioned off in 5 years. Lower mortality, especially suicide mortality among disability pensioners, suggests that the decision on a permanent disability pension, indicating for its part the activation of the service system, might be a relief to schizophrenic patients, helping them cope with illness. The retirement process has regional differences, which may be caused by the regional nature of treatment and resources.
authors.affiliation: Social and Mental Health Services, City of Oulu, Finland. marjo.kiviniemi@oulu.fi
authors.forename: Marjo
authors.initials: M
authors.lastname: Kiviniemi
authors.forename: Jaana
authors.initials: J
authors.lastname: Suvisaari
authors.forename: Sami
authors.initials: S
authors.lastname: Pirkola
authors.forename: Kristian
authors.initials: K
authors.lastname: Läksy
authors.forename: Unto
authors.initials: U
authors.lastname: Häkkinen
authors.forename: Matti
authors.initials: M
authors.lastname: Isohanni
authors.forename: Helinä
authors.initials: H
authors.lastname: Hakko
mesh_terms: D000328:Adult; D002423:Cause of Death; D003156:Community Mental Health Services; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005843:Geography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D010415:Pensions / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012042:Registries; D012179:Retirement / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000401:mortality* / Q000628:therapy; D012565:Schizophrenic Psychology; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult