1. Tiina Helena Pensola, PhD
Occupational differences in the incidence of the disability pensions due to mental disorders in Finland
Tiina Helena Pensola, PhD

2. Aims:
To show the change of the incidence of disability pensions (DP) over the years in Finland
To show the IDP due to depression in various occupations
To show the IDP due to other mental disorders in various occupations
To consider the effect of unemployment on found differences

3. Incidence of disability pensions* (per 10.000 person-years) by
age,period (1= , 2= ), cause and sex
men
mies
women
nainen
200
150
New pensions /
100 50 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2
20-29
30-39
40-49
50-59
60-65
20-29
30-39
40-49
50-59
60-65
Neoplasms
Other causes
Mental disorders
Cardiovascular diseases
Musculoskeletal disorders
*earning-based pensions
VTT Tiina Pensola

4. Economic activity in and during 5 previous years for men aged who either started or not their dp during that period (follow-up is done untill the age of 18)
DP in
No DP

5. Economic activity in and during 5 previous years for women aged who either started or not their dp during that period (follow-up is done untill the age of 18)
DP in
No DP in

6. Age-standardized incidence of DPs according to the cause of DP in 1997–2009 among persons aged (private sector)
3,5
Musculoskeletal disorders -
3,0
Other diseases
2,5
Mental disorders ‰
2,0
1,5
1,0
Cardiovascular diseases
0,5
0,0 96 97 98 99 00 01 02 03 04 05 06 07
088 09
Source:Finnish Centre for Pensions

7. Recipients of new DPs due to selected mental disorders in the
private sector in 1983–2009.
Number
Depression
(296, F32, F33)
Schitsophrenia
(295, F20, F23, F25)
Alcohol related
(291, 303, F10)2
Neurosis
(300, F34, F40-42, F44, F45 , F48)
Personality disorders
(301, F21, F60–62 )
1 In 1996 there was a change from ICD-9 to ICD-10. This has been tried to take into account and group
diseases in the comparable way.
Source: Finnish Centre for Pensions

8. Data: based on various registries in Statistics Finland and Finnish Centre for Pensions
men and women aged 30–64 (10% sample of the population)
persons retired on disability pension during the follow-up (1997–2006)
there were 465 occupations in the data: we grouped them into 80 occupational groups
Representativeness of the data are good 8

9. The results are based on the following publications
1. Occupations and depression-based disability pensions
Tiina Pensola ja Raija Gould, 2009
2. Occupations and disability pensions
Tiina Pensola, Raija Gould, Anu Polvinen 2010
You can find study 1 on the following pages: 9

10. Distribution of the causes of DPs (n=21 729)

11. Incidence on DPs due to all mental disorders by occupational group, gender and year/age

12. Excess incidence of DPs due to mental disorders, women & men aged 30-64

13. Incidence on DPs due to depression by occupational group, gender and year/age

14. Occupations that have excess incidence of depression-based DPs
Women aged 30-49
Women aged 50-64

15. Incidence of depression based DP for women and men in various occupations

16. Depression has multiple causes
Personality
Depression
Psyco-social stress
Work load ?
Genetic factors

17. IDP by the length of unemployment, women and men aged 30-64, 1997-2006
Depression (per 100,000)
Other mental disorders

18. Economic activity 5 years before the DP due to depression and other mental disorders, men in professional and manual occupations
Depression
Other mental disorders than depression

19. Economic activity 5 years before the DP due to depression or other mental disorders, women in professional and manual occupations
Depression
Other mental disorders than depression

20. Incidence of depression based DP by occupational group & marital status

21. Men and women who have due to affective or anxiety disorders used health services ( ), have applied for rehabilitation organinized by the Social Insurance Institute of Finland (2004), and who have started their DP
Lähteet: terveyspalvelut (Terveys2000) kuntoutus (Kurre) eläkkeet (Pensola ym. 2010)

22. To conclude: Occupational differences in incidence of DPs are large
In professional occupations there is a
peak in incidence of depression based
DPs after age 50 (particularly in women)
There are many causes to DPs due to
mental disorders: the causes differ by
age, gender and occupation
All of these causes are not related
to work, however work can be
a support or a burden
Role of alcohol behind disability?

23. Conclusions: depression should not lead to dp
Work atmosphere (tense), work load, haste, psychosocial factors in general affect work ability and disability
Social support (at work and home) affect the process of disability
The effects of unemployment can have a longlasting effect on work ability
Vocational rehabilition should be started before a person is disabled and is drifted out from work