title: Personality disorders are important risk factors for disability pensioning.
abstract: OBJECTIVE
  To determine whether personality disorders (PDs) are associated with increased risk of disability pensioning in young adults, independent of other common mental disorders.
  
  
  METHODS
  2,770 young adults from the general population were assessed for PDs by the Structured Interview for DSM-IV Personality, and for common mental disorders by the Composite of International Diagnostic Interview. These data were linked to the Norwegian National Insurance Administration's recordings of disability benefits for a 10-year period. Logistic regression analyses were applied to investigate the association between PDs and disability pensioning. The analyses were conducted for three types of PD measures: categorical diagnoses (any PD), dimensional scores of individual PDs and higher order components retrieved by principal component analyses.
  
  
  RESULTS
  Having any PD was strongly associated with disability pensioning, regardless of disability diagnosis. The estimated odds ratio (OR) was substantially higher for PDs [OR 4.69 (95% confidence interval (CI) 2.6-8.5)] than for mood disorders [OR 1.3 (CI 0.7-2.3)] and anxiety disorders [OR 2.3 (CI 1.3-4.3)]. Measured dimensionally, all PD traits except antisocial traits were significantly associated with disability pensioning. After adjusting for co-occurring traits of other PDs, only schizoid, dependent and borderline PD traits showed a significant positive association with disability pension, while antisocial traits showed a significant negative association. The principal component analyses showed that negative affectivity, psychoticism, and detachment was associated with an increased risk of disability pensioning, while antagonism/disinhibition and obsessivity were not.
  
  
  CONCLUSIONS
  PDs are strongly associated with disability pensioning in young adults, and might be more important predictors of work disability than anxiety and depressive disorders. Certain aspects of pathologic personalities are particularly important predictors of disability.
authors.affiliation: Department of Mental Health, Norwegian Institute of Public Health, Nydalen, Box 4404, 0403, Oslo, Norway, kristian.ostby@fhi.no.
authors.forename: Kristian Amundsen
authors.initials: KA
authors.lastname: Østby
authors.forename: Nikolai
authors.initials: N
authors.lastname: Czajkowski
authors.forename: Gun Peggy
authors.initials: GP
authors.lastname: Knudsen
authors.forename: Eivind
authors.initials: E
authors.lastname: Ystrom
authors.forename: Line C
authors.initials: LC
authors.lastname: Gjerde
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Kendler
authors.forename: Ragnhild E
authors.initials: RE
authors.lastname: Ørstavik
authors.forename: Ted
authors.initials: T
authors.lastname: Reichborn-Kjennerud
mesh_terms: D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D009664:Norway; D016017:Odds Ratio; D010415:Pensions; D010554:Personality Disorders / Q000175:diagnosis*; D012307:Risk Factors; D055815:Young Adult