Trajectories of mental health before and after old-age and disability retirement: a register-based study on purchases of psychotropic drugs

Research output: Contribution to journalArticleScientificpeer-review

Abstract

OBJECTIVES: Retirement from paid work is a major life event facing increasingly large numbers of people in the coming years. We examined trajectories of mental health five years before and five years after old-age and disability retirement using data on purchases of psychotropic drugs.

METHODS: The study included all employees from the City of Helsinki, Finland, retiring between 2000-2008 due to old age (N=4456) or disability (N=2549). Purchases of psychotropic drugs were analyzed in 20 3-month intervals before and after retirement using graphical methods and growth curve models.

RESULTS: Old-age retirement was unrelated to purchases of psychotropic drugs. Among disability retirees, psychotropic medication tripled before retirement. The average increase was 0.95 [95% confidence interval (95% CI) 0.73-1.16] daily defined doses (DDD) 5-1.5 years before retirement; from 1.5 years until retirement it was 5.68 DDD (95% CI 5.33-6.03) for each 3-month interval. After disability retirement, purchases of antidepressants decreased on average by 0.40 DDD (95% CI 0.57-0.23) for each 3-month interval, those of hypnotics and sedatives increased by 0.30 DDD (95% CI 0.12-0.47), and no changes were seen for other psychotropic drugs. The changes before and after retirement were largest among those who retired due to mental disorders and those whose retirement had been granted as temporary.

CONCLUSIONS: While no overall decrease in psychotropic medication after retirement was observed, purchases of antidepressants decreased after disability retirement. Long-term trajectories suggest that disability retirement might be prevented if mental health problems were tackled more efficiently earlier in the pre-retirement period.

Original languageEnglish
JournalScandinavian Journal of Work, Environment & Health
Volume38
Issue number5
Pages (from-to)409-417
Number of pages9
ISSN0355-3140
DOIs
Publication statusPublished - 2012
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 3142 Public health care science, environmental and occupational health
  • disability pension
  • health trejectory
  • medication
  • register data
  • registe rlinkage
  • registry

Cite this

@article{2fe58330262245ca82bd206feee212fc,
title = "Trajectories of mental health before and after old-age and disability retirement: a register-based study on purchases of psychotropic drugs",
abstract = "OBJECTIVES: Retirement from paid work is a major life event facing increasingly large numbers of people in the coming years. We examined trajectories of mental health five years before and five years after old-age and disability retirement using data on purchases of psychotropic drugs. METHODS: The study included all employees from the City of Helsinki, Finland, retiring between 2000-2008 due to old age (N=4456) or disability (N=2549). Purchases of psychotropic drugs were analyzed in 20 3-month intervals before and after retirement using graphical methods and growth curve models. RESULTS: Old-age retirement was unrelated to purchases of psychotropic drugs. Among disability retirees, psychotropic medication tripled before retirement. The average increase was 0.95 [95{\%} confidence interval (95{\%} CI) 0.73-1.16] daily defined doses (DDD) 5-1.5 years before retirement; from 1.5 years until retirement it was 5.68 DDD (95{\%} CI 5.33-6.03) for each 3-month interval. After disability retirement, purchases of antidepressants decreased on average by 0.40 DDD (95{\%} CI 0.57-0.23) for each 3-month interval, those of hypnotics and sedatives increased by 0.30 DDD (95{\%} CI 0.12-0.47), and no changes were seen for other psychotropic drugs. The changes before and after retirement were largest among those who retired due to mental disorders and those whose retirement had been granted as temporary. CONCLUSIONS: While no overall decrease in psychotropic medication after retirement was observed, purchases of antidepressants decreased after disability retirement. Long-term trajectories suggest that disability retirement might be prevented if mental health problems were tackled more efficiently earlier in the pre-retirement period.",
keywords = "3142 Public health care science, environmental and occupational health, disability pension, health trejectory, medication, register data, registe rlinkage, registry",
author = "Mikko Laaksonen and Niina Mets{\"a}-Simola and Pekka Martikainen and Olli Pietil{\"a}inen and Ossi Rahkonen and Raija Gould and Timo Partonen and Eero Lahelma",
note = "WOS:000308570400003 Volume: Proceeding volume:",
year = "2012",
doi = "10.5271/sjweh.3290",
language = "English",
volume = "38",
pages = "409--417",
journal = "Scandinavian Journal of Work, Environment & Health",
issn = "0355-3140",
publisher = "SCANDINAVIAN JOURNAL WORK ENVIRONMENT & HEALTH",
number = "5",

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TY - JOUR

T1 - Trajectories of mental health before and after old-age and disability retirement

T2 - a register-based study on purchases of psychotropic drugs

AU - Laaksonen, Mikko

AU - Metsä-Simola, Niina

AU - Martikainen, Pekka

AU - Pietiläinen, Olli

AU - Rahkonen, Ossi

AU - Gould, Raija

AU - Partonen, Timo

AU - Lahelma, Eero

N1 - WOS:000308570400003 Volume: Proceeding volume:

PY - 2012

Y1 - 2012

N2 - OBJECTIVES: Retirement from paid work is a major life event facing increasingly large numbers of people in the coming years. We examined trajectories of mental health five years before and five years after old-age and disability retirement using data on purchases of psychotropic drugs. METHODS: The study included all employees from the City of Helsinki, Finland, retiring between 2000-2008 due to old age (N=4456) or disability (N=2549). Purchases of psychotropic drugs were analyzed in 20 3-month intervals before and after retirement using graphical methods and growth curve models. RESULTS: Old-age retirement was unrelated to purchases of psychotropic drugs. Among disability retirees, psychotropic medication tripled before retirement. The average increase was 0.95 [95% confidence interval (95% CI) 0.73-1.16] daily defined doses (DDD) 5-1.5 years before retirement; from 1.5 years until retirement it was 5.68 DDD (95% CI 5.33-6.03) for each 3-month interval. After disability retirement, purchases of antidepressants decreased on average by 0.40 DDD (95% CI 0.57-0.23) for each 3-month interval, those of hypnotics and sedatives increased by 0.30 DDD (95% CI 0.12-0.47), and no changes were seen for other psychotropic drugs. The changes before and after retirement were largest among those who retired due to mental disorders and those whose retirement had been granted as temporary. CONCLUSIONS: While no overall decrease in psychotropic medication after retirement was observed, purchases of antidepressants decreased after disability retirement. Long-term trajectories suggest that disability retirement might be prevented if mental health problems were tackled more efficiently earlier in the pre-retirement period.

AB - OBJECTIVES: Retirement from paid work is a major life event facing increasingly large numbers of people in the coming years. We examined trajectories of mental health five years before and five years after old-age and disability retirement using data on purchases of psychotropic drugs. METHODS: The study included all employees from the City of Helsinki, Finland, retiring between 2000-2008 due to old age (N=4456) or disability (N=2549). Purchases of psychotropic drugs were analyzed in 20 3-month intervals before and after retirement using graphical methods and growth curve models. RESULTS: Old-age retirement was unrelated to purchases of psychotropic drugs. Among disability retirees, psychotropic medication tripled before retirement. The average increase was 0.95 [95% confidence interval (95% CI) 0.73-1.16] daily defined doses (DDD) 5-1.5 years before retirement; from 1.5 years until retirement it was 5.68 DDD (95% CI 5.33-6.03) for each 3-month interval. After disability retirement, purchases of antidepressants decreased on average by 0.40 DDD (95% CI 0.57-0.23) for each 3-month interval, those of hypnotics and sedatives increased by 0.30 DDD (95% CI 0.12-0.47), and no changes were seen for other psychotropic drugs. The changes before and after retirement were largest among those who retired due to mental disorders and those whose retirement had been granted as temporary. CONCLUSIONS: While no overall decrease in psychotropic medication after retirement was observed, purchases of antidepressants decreased after disability retirement. Long-term trajectories suggest that disability retirement might be prevented if mental health problems were tackled more efficiently earlier in the pre-retirement period.

KW - 3142 Public health care science, environmental and occupational health

KW - disability pension

KW - health trejectory

KW - medication

KW - register data

KW - registe rlinkage

KW - registry

UR - http://www.sjweh.fi/show_abstract.php?abstract_id=3290

U2 - 10.5271/sjweh.3290

DO - 10.5271/sjweh.3290

M3 - Article

VL - 38

SP - 409

EP - 417

JO - Scandinavian Journal of Work, Environment & Health

JF - Scandinavian Journal of Work, Environment & Health

SN - 0355-3140

IS - 5

ER -