Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2005 Jan;59(1):70–74. doi: 10.1136/jech.2003.010702

Depression and early retirement: prospective population based study in middle aged men

M Karpansalo 1, J Kauhanen 1, T Lakka 1, P Manninen 1, G Kaplan 1, J Salonen 1
PMCID: PMC1763370  PMID: 15598730

Abstract

Background: Mental depression is an important health problem in many countries. It reduces productivity at work and is the fastest increasing reason for early retirement.

Methods: This study followed up a Finnish cohort of 1726 men from 1984 to 2000. Depression was assessed at baseline by HPL depression score. Pension records were obtained from the national pension registers. Cox's regression analysis was used to estimate the associations of depression with the risk of all disability pensions combined, separately for different causes of disability, and non-illness based pension.

Results: During the follow up, 839 men (48.6%) received a disability pension. A total of 142 men (16.9% of all disability pensions) retired because of mental disorder and of these, 75 (52.8%) because of depression. After adjustment for the potential confounders, men in the highest third of depression score had an increased risk of non-illness based pension (RR 1.86 95% CI 1.37 to 2.51) and disability pension attributable to mental disorders (RR 2.74, 95% CI 1.68 to 4.46), chronic somatic diseases (RR 1.68, 95% CI 1.05 to 2.71), cardiovascular diseases (RR 1.61, 95% CI 1.12 to 2.32). The mean age of retirement for men with a high and low depression score was 57.6 years (SD 3.87) and 59.1 years (SD 3.65) (p<0.001) respectively.

Conclusions: A high depression score predicted disability attributable to any cause, especially mental disorders, and non-illness based pensions. Depressed people retired on average 1.5 years younger than those without depression. Further studies are needed to elucidate the pathways of how mental depression leads people to seek retirement pension.

Full Text

The Full Text of this article is available as a PDF (68.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Armenian H. K., Pratt L. A., Gallo J., Eaton W. W. Psychopathology as a predictor of disability: a population-based follow-up study in Baltimore, Maryland. Am J Epidemiol. 1998 Aug 1;148(3):269–275. doi: 10.1093/oxfordjournals.aje.a009635. [DOI] [PubMed] [Google Scholar]
  2. Aromaa A., Raitasalo R., Reunanen A., Impivaara O., Heliövaara M., Knekt P., Lehtinen V., Joukamaa M., Maatela J. Depression and cardiovascular diseases. Acta Psychiatr Scand Suppl. 1994;377:77–82. doi: 10.1111/j.1600-0447.1994.tb05807.x. [DOI] [PubMed] [Google Scholar]
  3. Aronen E. T., Soininen M. Childhood depressive symptoms predict psychiatric problems in young adults. Can J Psychiatry. 2000 Jun;45(5):465–470. doi: 10.1177/070674370004500507. [DOI] [PubMed] [Google Scholar]
  4. Booth-Kewley S., Friedman H. S. Psychological predictors of heart disease: a quantitative review. Psychol Bull. 1987 May;101(3):343–362. [PubMed] [Google Scholar]
  5. Broadhead W. E., Blazer D. G., George L. K., Tse C. K. Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA. 1990 Nov 21;264(19):2524–2528. [PubMed] [Google Scholar]
  6. Conti D. J., Burton W. N. The economic impact of depression in a workplace. J Occup Med. 1994 Sep;36(9):983–988. [PubMed] [Google Scholar]
  7. Dening T. R., Chi L. Y., Brayne C., Huppert F. A., Paykel E. S., O'Connor D. W. Changes in self-rated health, disability and contact with services in a very elderly cohort: a 6-year follow-up study. Age Ageing. 1998 Jan;27(1):23–33. doi: 10.1093/ageing/27.1.23. [DOI] [PubMed] [Google Scholar]
  8. Druss B. G., Rosenheck R. A., Sledge W. H. Health and disability costs of depressive illness in a major U.S. corporation. Am J Psychiatry. 2000 Aug;157(8):1274–1278. doi: 10.1176/appi.ajp.157.8.1274. [DOI] [PubMed] [Google Scholar]
  9. Graney M. J. The reciprocal relationship between disability and depression. J Am Geriatr Soc. 2000 Apr;48(4):452–453. doi: 10.1111/j.1532-5415.2000.tb04706.x. [DOI] [PubMed] [Google Scholar]
  10. Hays R. D., Wells K. B., Sherbourne C. D., Rogers W., Spritzer K. Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry. 1995 Jan;52(1):11–19. doi: 10.1001/archpsyc.1995.03950130011002. [DOI] [PubMed] [Google Scholar]
  11. Kaplan G. A., Roberts R. E., Camacho T. C., Coyne J. C. Psychosocial predictors of depression. Prospective evidence from the human population laboratory studies. Am J Epidemiol. 1987 Feb;125(2):206–220. doi: 10.1093/oxfordjournals.aje.a114521. [DOI] [PubMed] [Google Scholar]
  12. Kauhanen J., Kaplan G. A., Goldberg D. E., Salonen J. T. Beer binging and mortality: results from the Kuopio ischaemic heart disease risk factor study, a prospective population based study. BMJ. 1997 Oct 4;315(7112):846–851. doi: 10.1136/bmj.315.7112.846. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kivelä S. L., Pahkala K. Depressive disorder as a predictor of physical disability in old age. J Am Geriatr Soc. 2001 Mar;49(3):290–296. doi: 10.1046/j.1532-5415.2001.4930290.x. [DOI] [PubMed] [Google Scholar]
  14. Krause N., Lynch J., Kaplan G. A., Cohen R. D., Goldberg D. E., Salonen J. T. Predictors of disability retirement. Scand J Work Environ Health. 1997 Dec;23(6):403–413. doi: 10.5271/sjweh.262. [DOI] [PubMed] [Google Scholar]
  15. Lakka H. M., Lakka T. A., Tuomilehto J., Sivenius J., Salonen J. T. Hyperinsulinemia and the risk of cardiovascular death and acute coronary and cerebrovascular events in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Arch Intern Med. 2000 Apr 24;160(8):1160–1168. doi: 10.1001/archinte.160.8.1160. [DOI] [PubMed] [Google Scholar]
  16. Lakka T. A., Laukkanen J. A., Rauramaa R., Salonen R., Lakka H. M., Kaplan G. A., Salonen J. T. Cardiorespiratory fitness and the progression of carotid atherosclerosis in middle-aged men. Ann Intern Med. 2001 Jan 2;134(1):12–20. doi: 10.7326/0003-4819-134-1-200101020-00008. [DOI] [PubMed] [Google Scholar]
  17. Leino P., Magni G. Depressive and distress symptoms as predictors of low back pain, neck-shoulder pain, and other musculoskeletal morbidity: a 10-year follow-up of metal industry employees. Pain. 1993 Apr;53(1):89–94. doi: 10.1016/0304-3959(93)90060-3. [DOI] [PubMed] [Google Scholar]
  18. Lin E. H., VonKorff M., Russo J., Katon W., Simon G. E., Unützer J., Bush T., Walker E., Ludman E. Can depression treatment in primary care reduce disability? A stepped care approach. Arch Fam Med. 2000 Nov-Dec;9(10):1052–1058. doi: 10.1001/archfami.9.10.1052. [DOI] [PubMed] [Google Scholar]
  19. Linn M. W., Hunter K. I., Linn B. S. Self-assessed health, impairment and disability in anglo, black and cuban elderly. Med Care. 1980 Mar;18(3):282–288. doi: 10.1097/00005650-198003000-00003. [DOI] [PubMed] [Google Scholar]
  20. Linn M. W., Linn B. S., Skyler J. S., Harris R. The importance of self-assessed health in patients with diabetes. Diabetes Care. 1980 Sep-Oct;3(5):599–606. doi: 10.2337/diacare.3.5.599. [DOI] [PubMed] [Google Scholar]
  21. Manninen P., Heliövaara M., Riihimäki H., Mäkelä P. Does psychological distress predict disability? Int J Epidemiol. 1997 Oct;26(5):1063–1070. doi: 10.1093/ije/26.5.1063. [DOI] [PubMed] [Google Scholar]
  22. Nordstrom D. L., Vierkant R. A., Layde P. M., Smith M. J. Comparison of self-reported and expert-observed physical activities at work in a general population. Am J Ind Med. 1998 Jul;34(1):29–35. doi: 10.1002/(sici)1097-0274(199807)34:1<29::aid-ajim5>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  23. Olfson M., Fireman B., Weissman M. M., Leon A. C., Sheehan D. V., Kathol R. G., Hoven C., Farber L. Mental disorders and disability among patients in a primary care group practice. Am J Psychiatry. 1997 Dec;154(12):1734–1740. doi: 10.1176/ajp.154.12.1734. [DOI] [PubMed] [Google Scholar]
  24. Ormel J., Vonkorff M., Oldehinkel A. J., Simon G., Tiemens B. G., Ustün T. B. Onset of disability in depressed and non-depressed primary care patients. Psychol Med. 1999 Jul;29(4):847–853. doi: 10.1017/s0033291799008600. [DOI] [PubMed] [Google Scholar]
  25. Ostlin P. Occupational history, self reported chronic illness, and mortality: a follow up of 25,586 Swedish men and women. J Epidemiol Community Health. 1990 Mar;44(1):12–16. doi: 10.1136/jech.44.1.12. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Pelkonen M., Marttunen M., Pulkkinen E., Laippala P., Lönnqvist J., Aro H. Disability pensions in severely disturbed in-patient adolescents. Twenty-year prospective study. Br J Psychiatry. 1998 Feb;172:159–163. doi: 10.1192/bjp.172.2.159. [DOI] [PubMed] [Google Scholar]
  27. Penninx B. W., Leveille S., Ferrucci L., van Eijk J. T., Guralnik J. M. Exploring the effect of depression on physical disability: longitudinal evidence from the established populations for epidemiologic studies of the elderly. Am J Public Health. 1999 Sep;89(9):1346–1352. doi: 10.2105/ajph.89.9.1346. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Roberts R. E., Kaplan G. A., Shema S. J., Strawbridge W. J. Does growing old increase the risk for depression? Am J Psychiatry. 1997 Oct;154(10):1384–1390. doi: 10.1176/ajp.154.10.1384. [DOI] [PubMed] [Google Scholar]
  29. Salminen J. K., Saarijärvi S., Raitasalo R. Depression and disability pension in Finland. Acta Psychiatr Scand. 1997 Mar;95(3):242–243. doi: 10.1111/j.1600-0447.1997.tb09626.x. [DOI] [PubMed] [Google Scholar]
  30. Salonen J. T. Is there a continuing need for longitudinal epidemiologic research? The Kuopio Ischaemic Heart Disease Risk Factor Study. Ann Clin Res. 1988;20(1-2):46–50. [PubMed] [Google Scholar]
  31. Salonen J. T., Nyyssönen K., Tuomainen T. P., Mäenpä P. H., Korpela H., Kaplan G. A., Lynch J., Helmrich S. P., Salonen R. Increased risk of non-insulin dependent diabetes mellitus at low plasma vitamin E concentrations: a four year follow up study in men. BMJ. 1995 Oct 28;311(7013):1124–1127. doi: 10.1136/bmj.311.7013.1124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Schonfeld W. H., Verboncoeur C. J., Fifer S. K., Lipschutz R. C., Lubeck D. P., Buesching D. P. The functioning and well-being of patients with unrecognized anxiety disorders and major depressive disorder. J Affect Disord. 1997 Apr;43(2):105–119. doi: 10.1016/s0165-0327(96)01416-4. [DOI] [PubMed] [Google Scholar]
  33. Schuurman A. G., van den Akker M., Ensinck K. T. J. L., Metsemakers J. F. M., Knottnerus J. A., Leentjens A. F. G., Buntinx F. Increased risk of Parkinson's disease after depression: a retrospective cohort study. Neurology. 2002 May 28;58(10):1501–1504. doi: 10.1212/wnl.58.10.1501. [DOI] [PubMed] [Google Scholar]
  34. Simon G. E., Katon W., Rutter C., VonKorff M., Lin E., Robinson P., Bush T., Walker E. A., Ludman E., Russo J. Impact of improved depression treatment in primary care on daily functioning and disability. Psychol Med. 1998 May;28(3):693–701. doi: 10.1017/s0033291798006588. [DOI] [PubMed] [Google Scholar]
  35. Simon G. E., Revicki D., Heiligenstein J., Grothaus L., VonKorff M., Katon W. J., Hylan T. R. Recovery from depression, work productivity, and health care costs among primary care patients. Gen Hosp Psychiatry. 2000 May-Jun;22(3):153–162. doi: 10.1016/s0163-8343(00)00072-4. [DOI] [PubMed] [Google Scholar]
  36. Tiihonen J., Pesonen U., Kauhanen J., Koulu M., Hallikainen T., Leskinen L., Salonen J. T. CYP2A6 genotype and smoking. Mol Psychiatry. 2000 Jul;5(4):347–348. doi: 10.1038/sj.mp.4000710. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES