Health related factors

Diagnoses in benefit certificates provide information on which diagnoses sickness absences and disability benefits are awarded for. But due to a number of reasons, these diagnoses provide limited information on the complex trajectories that contribute towards the awards. For example, risk factors beyond health are not reflected in diagnostic information. Patient and physician preferences influences which diagnoses are used, and practices among case managers influence which diagnoses qualify for benefit awards. Consequently, the studies undertaken in this project, where health information is gathered outside the benefit application setting, have several advantages.

           Our initial publications applying this approach, demonstrated that anxiety and depression are strong and independent risk factors for disability pensions officially awarded for non-psychiatric conditions. We have further found that although insomnia rarely is listed as the diagnostic cause for disability pensions, it is a strong and independent risk factor for disability pension awards. These findings suggested that the role of mental illnesses in disability benefits may be under-recognized and that we lack knowledge on which mental health factors that contribute to work disability.

           In our following studies, we have further explored the role of common mental illnesses like anxiety, depression and insomnia towards sickness absence and disability pension awards. We are currently undertaking studies where we examine how mental health may modify risk for disability in severe medical illnesses like cancer and cardiovascular disorders. We have also expanded our focus to a range of health problems, for example health anxiety and alcohol problems, and we have a continued strong focus on health beliefs, health perceptions, somatisation and functional disorders in relation to award of disability benefits.