title: Common mental and musculoskeletal disorders as predictors of disability retirement among Finns.
abstract: BACKGROUND
  The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disorders (MSD) to disability retirement is not known.
  
  
  METHODS
  A nationally representative sample (the Health 2000 survey) comprised 3943 occupationally active Finns aged 30-63. MSD and other chronic disorders were assessed by a physician in a standardized clinical examination, and CMD using the Composite International Diagnostic Interview. Disability pension data for 2000-2011 was retrieved from national pension records. Cox regression was used with censoring for death and pension other than that for disability. Covariate information was based on an interview.
  
  
  RESULTS
  The baseline prevalence of CMD was 9.4% and of MSD 31.1%. CMD co-occurred with MSD in 3.3% of participants. The risks inflicted by CMD and MSD were additive. Thirty-eight per cent of the co-morbid subjects, 18% of those with CMD and 19% of those with MSD retired prematurely during the average follow-up of 8.6 years. Compared with those with neither type of disorder, the hazard ratio (HR) for disability pension was 2.4 (95% CI 1.7-2.7) for CMD only, 2.2 (1.8-2.7) for MSD only, and 4.1 (2.9-5.7) for the occurrence of both, allowing for age, gender, other chronic disorders, working conditions, and socio-economic and lifestyle factors. No synergistic or antagonistic interactive effects were observed.
  
  
  CONCLUSIONS
  The determinants were measured only once and we had no information on incident disorders during the follow-up.
  
  
  CONCLUSIONS
  It is important to identify subjects with both mental and musculoskeletal complaints in order to efficiently support their work ability.
authors.affiliation: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland. Electronic address: leena.kaila-kangas@ttl.fi.
authors.forename: Leena
authors.initials: L
authors.lastname: Kaila-Kangas
authors.affiliation: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Eija
authors.initials: E
authors.lastname: Haukka
authors.affiliation: Department of Health Sciences, University of Tampere, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Miranda
authors.affiliation: Centre of Expertise for Work Organisations, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Teija
authors.initials: T
authors.lastname: Kivekäs
authors.affiliation: Centre of Expertise for Work Organisations, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Ahola
authors.affiliation: Creating Solutions, Statistics and Health Economics Team, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Ritva
authors.initials: R
authors.lastname: Luukkonen
authors.affiliation: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Rahman
authors.initials: R
authors.lastname: Shiri
authors.affiliation: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Sanna
authors.initials: S
authors.lastname: Kääriä
authors.affiliation: Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Heliövaara
authors.affiliation: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Leino-Arjas
mesh_terms: D000328:Adult; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D010415:Pensions; D015995:Prevalence; D012179:Retirement
keywords: Disability retirement; Mental health; Musculoskeletal disorders