Psychotropic medication before and after disability retirement by pre-retirement perceived work-related stress
: Halonen J.I., Chandola T., Hyde M., Leinonen T., Westerlund H., Aalto V., Pentti J., Laaksonen M., Stenholm S., Mänty M., Vahtera J., Oksanen T., Kivimäki M., Virtanen M., Lallukka T.
: 2020
: European Journal of Public Health
: European journal of public health
: Eur J Public Health
: 30
: 1
: 158
: 163
: 1101-1262
: 1464-360X
DOI: https://doi.org/10.1093/eurpub/ckz131
: https://research.utu.fi/converis/portal/detail/Publication/44848813
Register-based date and diagnosis of disability retirement of 2766 participants of the Finnish Public Sector study cohort were linked to survey data on ERI, social- and health-related covariates, and to national records on prescribed reimbursed psychotropic medication, measured as defined daily doses (DDDs). Follow-up for DDDs was 2-5 years before and after disability retirement. We assessed differences in the levels of DDDs before and after retirement among those with high vs. low level of pre-retirement ERI with repeated measures regression.
Retirement has been associated with improved mental health, but it is unclear how much this is due to the removal of work-related stressors. We examined rates of psychotropic medication use before and after the transition to disability retirement due to mental, musculoskeletal and other causes by pre-retirement levels of perceived work stress (effort-reward imbalance, ERI).\nThe level of psychotropic medication use over the transition to disability retirement due to mental, but not musculoskeletal or other, causes was modified by pre-retirement perceived work-related stress. This suggests that among people retiring due to mental disorders those who had stressful jobs benefit from retirement more than those with low levels of work-related stress.
Those with high (vs. low) levels of ERI used slightly more psychotropic medication before disability retirement due to mental disorders [rate ratio (RR) 1.14, 95% confidence intervals (CI) 0.94-1.37], but after retirement this difference attenuated (RR 0.94, 95% CI 0.80-1.10, P for interaction 0.02). Such a change was not observed for the other causes of disability retirement.
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