title: Disability pension and symptoms of anxiety and depression: a prospective comparison of farmers and other occupational groups. The HUNT Study, Norway.
abstract: OBJECTIVE
  Agriculture has undergone major changes, and farmers have been found to have a high prevalence of depression symptoms. We investigated the risk of work disability in Norwegian farmers compared with other occupational groups, as well as the associations between symptoms of anxiety and depression and future disability pension.
  
  
  METHODS
  We linked working participants of the HUNT2 Survey (1995-97) aged 20-61.9 years, of whom 3495 were farmers and 25,521 had other occupations, to national registry data on disability pension, with follow-up until 31 December 2010. We used Cox proportional hazards regression to estimate hazard ratios (HRs) of disability pension, and to investigate the associations between symptoms of anxiety and depression caseness at baseline (score on the anxiety or depression subscales of the Hospital Anxiety and Depression Scale (HADS) ≥8) and disability pension.
  
  
  RESULTS
  Farmers had a twofold increased risk of disability pension (age-adjusted and sex-adjusted HR 2.07, 95% CI 1.80 to 2.38) compared with higher grade professionals. Farmers with symptoms of depression caseness had a 53% increased risk of disability pension (HR 1.53, 95% CI 1.25 to 1.87) compared with farmers below the cut-off point of depression caseness symptoms, whereas farmers with symptoms of anxiety caseness had a 51% increased risk (HR 1.51, 95% CI 1.23 to 1.86).
  
  
  CONCLUSIONS
  Farmers have an increased risk of disability pension compared with higher grade professionals, but the risk is lower than in most other manual occupational groups. Farmers who report high levels of depression or anxiety symptoms are at substantially increased risk of future work disability, and the risk increase appears to be fairly similar across most occupational groups.
authors.affiliation: Hunt Research Centre, Department of Public Health and General Practice, Faculty of Medicine, the Norwegian University of Science and Technology (NTNU), Levanger, Norway.
authors.forename: Magnhild Oust
authors.identifier: http://orcid.org/0000-0001-6439-051X
authors.initials: MO
authors.lastname: Torske
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, The Norwegian University of Science and Technology, Trondheim, Norway Department of Occupational Medicine, St. Olav's University Hospital, Trondheim, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Hilt
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, The Norwegian University of Science and Technology, Trondheim, Norway Forensic Department and Research Centre, Bröset St. Olav's University Hospital, Trondheim, Norway.
authors.forename: Johan Håkon
authors.initials: JH
authors.lastname: Bjørngaard
authors.affiliation: Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark.
authors.forename: David
authors.identifier: http://orcid.org/0000-0003-1083-5784
authors.initials: D
authors.lastname: Glasscock
authors.affiliation: Hunt Research Centre, Department of Public Health and General Practice, Faculty of Medicine, the Norwegian University of Science and Technology (NTNU), Levanger, Norway Psychiatric Department, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway.
authors.forename: Steinar
authors.initials: S
authors.lastname: Krokstad
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D006233:Persons with Disabilities; D000067565:Farmers; D006801:Humans; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D009790:Occupations; D010415:Pensions; D011446:Prospective Studies; D055815:Young Adult
keywords: OCCUPATIONAL & INDUSTRIAL MEDICINE; PSYCHIATRY; PUBLIC HEALTH