title: Clustering of adversity in young adults on disability pension due to mental disorders: a latent class analysis.
abstract: OBJECTIVE
  Mental disorders are the leading cause of work disability among young adults. This study examined whether distinct classes could be identified among young adults on the basis of medical history before receiving a disability pension due to a mental disorder.
  
  
  METHODS
  Medical history was obtained from pension applications and attached medical certificates for 1163 individuals aged 18-34 years who, in 2008, received a disability pension due to a mental disorder. Using latent class analysis, 10 clinical and individual adversities and their associations with sex, age and diagnostic category were examined.
  
  
  RESULTS
  Three classes were identified: childhood adversity (prevalence, 33%), comorbidity (23%), and undefined (44%). The childhood adversity class was characterized by adverse events and symptoms reported during childhood and it associated with depressive disorders. The comorbidity class was characterized by comorbid mental disorders, suicide attempts and substance abuse and associated with younger age and bipolar disorder. The undefined class formed no distinct profile; individuals in this class had the lowest number of adversities and it associated with psychotic disorders.
  
  
  CONCLUSIONS
  The identification of subgroups characterized by childhood circumstances and comorbidity may help planning of prevention and support practices for young adults with mental disorders and risk of work disability.
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland. matti.joensuu@ttl.fi.
authors.forename: Matti
authors.initials: M
authors.lastname: Joensuu
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.
authors.forename: Pauliina
authors.initials: P
authors.lastname: Mattila-Holappa
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Ahola
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.
authors.forename: Jenni
authors.initials: J
authors.lastname: Ervasti
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.|Clinicum, University of Helsinki, Helsinki, Finland.|Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.
authors.forename: Teija
authors.initials: T
authors.lastname: Kivekäs
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.
authors.forename: Aki
authors.initials: A
authors.lastname: Koskinen
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.|Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
mesh_terms: D000293:Adolescent; D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000706:statistics & numerical data*; D016000:Cluster Analysis; D015897:Comorbidity; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D010415:Pensions / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
keywords: Disability; Employment; Insurance; Risk factors; Work