Mortality in persons with disability pension due to common mental disorders: A cohort study of Swedish construction workers

Aims: This study investigated mortality in disability pensions due to common mental disorder, and variation over time after first receiving disability pension. Methods: Objectives were explored in 301,863 construction workers (97.2% men) recruited through healthcare examinations from 1971–1993. By linking with the Swedish National Insurance Agency registers, disability pensions until 2014 were identified. Common mental disorder was defined as disability pension diagnosis due to anxiety, stress-related disorders or moderate depression. Mortality was calculated in all-psychiatric diagnosis and diagnostic sub-groups, and compared to persons without disability pensions, using Poisson regression. Additional analyses were stratified by age at follow-up. Results: In total 6030 subjects received disability pensions based on psychiatric diagnoses, and 2624 constituted common mental disorder. Analyses in an all-psychiatric diagnosis displayed increased mortality risks in men (relative risk 3.6; 95% confidence interval 3.3–3.9) and women (relative risk 2.1; 95% confidence interval 1.6–2.6). Common mental disorder was associated with mortality, especially in men (relative risk 2.5; 95% confidence interval 2.2–2.8). Increased relative risks in alcohol and substance abuse were also observed. Results in analyses stratified by age at follow-up displayed persistent high relative risks for mortality in older ages (75–89 years) in men in all-psychiatric disability pensions diagnosis (relative risk 2.8; 95% confidence interval 2.1–3.7) and common mental disorder diagnosis (relative risk 2.6; 95% confidence interval 1.8–3.6), compared to men without disability pensions. Similar results were found in women, but few cases lowered the precision of estimates. Conclusions: This study shows that disability pension based on common mental disorders, often regarded as a ‘lighter’ psychiatric diagnosis, is a risk for early mortality in construction workers, even several years after first receiving disability pension.

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