Work disability before and after incident myocardial infarction and subsequent common mental disorder. (13th November 2019)

• Record Type: Journal Article
• Authors: Bokenberger, K; Rahman, S; Wang, M; Vaez, M; Dorner, T E; Helgesson, M; Ivert, T; Mittendorfer-Rutz, E
• Is Part Of: European journal of public health. Volume 29(2019)Supplement 4
• Publication Date: 2019-11-13
• Subjects: Epidemiology -- Europe -- Periodicals; Public health -- Europe -- Periodicals; 362.109405
• DOI: 10.1093/eurpub/ckz187.111
• Languages: English
• ISSNs: 1101-1262

Abstract

Abstract: Background: This study investigated the extent to which work-disability patterns including sickness absence and disability pension (SA/DP) before and after acute myocardial infarction (AMI) were associated with subsequent common mental disorders (CMDs) such as depression and anxiety in AMI patients without previous CMD. Methods: A cohort of 11, 493 patients aged 26-64 years without previous CMD with incident AMI during 2008-2010 were followed up for CMD measured as antidepressant prescription through 2013. Four SA/DP trajectory groups during the 3 years pre-AMI and 1 year post-AMI were identified. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated in Cox models. Results: Higher pre-AMI SA/DP levels (>1-12 months/year), compared to the majority of patients (78%) following low increasing annual levels (increasing up to 1 month/year) of pre-AMI SA/DP, were associated with a 40-60% increased CMD rate. Regarding post-AMI findings, constant high (∼25-30 days/month) and steeply decreasing SA/DP levels within the first 3 months were associated with a 76% and 35% higher CMD rate, respectively, compared to constant low (<1 days/month) levels. Conversely, a gradually decreasing pattern of post-AMI SA/DP over a 12-month period suggested protective influences for CMD (HR = 0.80), even after adjusting for sociodemographic and medical factors. Conclusions: This is the first study to demonstrate that pre- and post-AMI work disability patterns are associated with subsequent CMD risk in AMI patients. Work disability patterns should be considered in clinical practice as an indicator of AMI prognosis in terms of CMD risk. Key messages: Increasing and high persistent levels of pre-AMI work disability are associated with higher risk of subsequent CMD, while gradually decreasing post-AMI work disability has a favourable CMD prognosis. Pre- and post-AMI patterns of work disability (sickness absence and disability pension) can be a useful marker in terms of CMD prognosis.