title: Trajectories of mental health before and after old-age and disability retirement: a register-based study         on purchases of psychotropic drugs.
abstract: OBJECTIVE
  Retirement from paid work is a major life event facing increasingly large numbers of people in         the coming years. We examined trajectories of mental health five years before and five years after old-age and         disability retirement using data on purchases of psychotropic drugs.
  
  
  METHODS
  The study included all employees from the         City of Helsinki, Finland, retiring between 2000-2008 due to old age (N=4456) or disability (N=2549). Purchases         of psychotropic drugs were analyzed in 20 3-month intervals before and after retirement using graphical methods and         growth curve models.
  
  
  RESULTS
  Old-age retirement was unrelated to purchases of psychotropic drugs. Among disability         retirees, psychotropic medication tripled before retirement. The average increase was 0.95 [95% confidence interval         (95% CI) 0.73-1.16] daily defined doses (DDD) 5-1.5 years before retirement; from 1.5 years until         retirement it was 5.68 DDD (95% CI 5.33-6.03) for each 3-month interval. After disability retirement, purchases         of antidepressants decreased on average by 0.40 DDD (95% CI 0.57-0.23) for each 3-month interval, those of         hypnotics and sedatives increased by 0.30 DDD (95% CI 0.12-0.47), and no changes were seen for other psychotropic         drugs. The changes before and after retirement were largest among those who retired due to mental disorders and those         whose retirement had been granted as temporary.
  
  
  CONCLUSIONS
  While no overall decrease in psychotropic medication after         retirement was observed, purchases of antidepressants decreased after disability retirement. Long-term trajectories         suggest that disability retirement might be prevented if mental health problems were tackled more efficiently earlier         in the pre-retirement period.
authors.affiliation: Finnish Centre for Pensions, 00065 Eläketurvakeskus, Finland. mikko.laaksonen@etk.fi
authors.forename: Mikko
authors.initials: M
authors.lastname: Laaksonen
authors.forename: Niina
authors.initials: N
authors.lastname: Metsä-Simola
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
authors.forename: Olli
authors.initials: O
authors.lastname: Pietiläinen
authors.forename: Ossi
authors.initials: O
authors.lastname: Rahkonen
authors.forename: Raija
authors.initials: R
authors.lastname: Gould
authors.forename: Timo
authors.initials: T
authors.lastname: Partonen
authors.forename: Eero
authors.initials: E
authors.lastname: Lahelma
mesh_terms: D000368:Aged; D006233:Persons with Disabilities; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008603:Mental Health; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012042:Registries
chemical_list: D011619:Psychotropic Drugs