title: Attachment to employment and education before work disability pension due to a mental disorder among young adults.
abstract: BACKGROUND
  We examined attachment to employment and education among young adults before they were granted a fixed-term work disability pension due to psychiatric diagnosis, and the factors associated with this attachment.
  
  
  METHODS
  The data comprised all persons aged 18-34 who received a new-onset fixed-term disability pension compensation due to a mental disorder in Finland in 2008 (N = 1163). The data were derived from pension applications and the enclosed medical records, and were linked to employment records from a period of three years before the disability pension. We analysed the factors associated with attachment to employment or education with log-binomial regression analysis.
  
  
  RESULTS
  Fifty percent of the participants were attached to employment or education before work disability pension. The attached were more often women; had higher basic and vocational education; had mood disorder rather than psychosis diagnosis as a primary diagnosis; and had no record of harmful alcohol use or drug use, or recorded symptoms of mental disorders already at school-age.
  
  
  CONCLUSIONS
  The level of attachment to employment or education before work disability pension is low among young adults with mental disorders and several risk factors predict poor attachment; severe or comorbid mental disorder, early-life psychiatric morbidity, substance use, male sex, low basic education, and lacking vocational education.
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, FIN-00250, Finland. pauliina.mattila-holappa@ttl.fi.
authors.forename: Pauliina
authors.initials: P
authors.lastname: Mattila-Holappa
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, FIN-00250, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Joensuu
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, FIN-00250, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Ahola
authors.affiliation: 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, Helsinki, FIN-00250, Finland.
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
mesh_terms: D000293:Adolescent; D000328:Adult; D006233:Persons with Disabilities / Q000523:psychology*; D004522:Educational Status; D004651:Employment / Q000523:psychology*; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D010415:Pensions; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Childhood; Comorbidity; Education; Employment; Mental disorders; Psychiatric diagnosis; Retrospective; Substance use