title: A 5-year prospective study of predictors for disability pension among patients with major depressive disorder.
abstract: OBJECTIVE
  There is a scarcity of prospective long-term studies on work disability caused by depression. We investigated predictors for disability pension among psychiatric patients with MDD.
  
  
  METHODS
  The Vantaa Depression Study followed up prospectively 269 psychiatric in- and out-patients with DSM-IV MDD for 5 years with a life chart, including 230 (91.3%) patients belonging to labour force. Information on disability pensions was obtained from interviews, patient records and registers.
  
  
  RESULTS
  Within 5 years, 20% of the patients belonging to labour force at baseline were granted a disability pension. In multivariate analyses, the significant baseline predictors for granted disability pension were age ≥50 years (HR = 3.91, P < 0.001), subjective inability to work (HR = 2.14, P = 0.008) and introversion (HR = 1.08, P = 0.049). When follow-up variables were included, the predictors were age more than 50 (OR = 6.25, P < 0.001), proportion of time spent depressed (OR = 14.6, P < 0.001), number of comorbid somatic disorders (OR = 1.47, P = 0.013) and lack of vocational education (OR = 2.38, P = 0.032).
  
  
  CONCLUSIONS
  Of psychiatric patients with depression, one-fifth were granted a disability pension within 5 years. Future disability pension can be predicted by baseline older age, personality factors, functional disability, lack of vocational education and comorbid somatic disorders. Longitudinally, accumulation of time spent depressed appears decisive for pensioning.
authors: Mood, Depression, and Suicidal Behaviour Unit, National Institute for Health and Welfare, Helsinki, Finland.
authors: I A K
authors: IA
authors: Holma
authors: K M
authors: KM
authors: Holma
authors: T K
authors: TK
authors: Melartin
authors: H J
authors: HJ
authors: Rytsälä
authors: E T
authors: ET
authors: Isometsä
mesh_terms: D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000503:physiopathology* / Q000523:psychology; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010415:Pensions / Q000706:statistics & numerical data*; D011446:Prospective Studies