Life dissatisfaction and subsequent work disability in an 11-year follow-up

Background. Mental disorders are associated with disability, but the long-term effects of low subjective well-being on work ability in general population are not known. In this study we investigated whether self-reported life dissatisfaction predicts work disability. Method. A nationwide sample of Finnish twins aged 18–54 years (N=22 136), unselected for health status responded to a health questionnaire with a four-item life satisfaction scale (range 4–20) covering interest, happiness, easiness and loneliness of life in 1975 and 1981. Cox regression for all subjects and conditional logistic regression for discordant twin pairs were used to compare the risk of subsequent work disability (N=1200) (Nationwide Disability Register) between the dissatisfied and satisfied. Results. Life dissatisfaction predicted subsequent (1977–87) work disability pension due to psychiatric and non-psychiatric causes among the healthy at baseline, and that due to psychiatric causes among the ill. After controlling for age, marital status, social class and health behaviour, these risks remained significant. Repeatedly reported (1975 and 1981) life dissatisfaction was strongly associated with increased (age-adjusted) risk of subsequent (1982–87) work disability due to psychiatric and also that due to non-psychiatric causes among the healthy. When twin pairs discordant for end-point disability status were analysed, risk differences related to life satisfaction were only slightly decreased, but they did not differ significantly between monozygotic and dizygotic pairs. Conclusion. Life dissatisfaction predicts subsequent work disability especially among the healthy.

[1]  J. Kaprio,et al.  Life satisfaction and suicide: a 20-year follow-up study. , 2001, The American journal of psychiatry.

[2]  C. Murray,et al.  Burden of disease--implications for future research. , 2001, JAMA.

[3]  J. Kaprio,et al.  Self-reported life satisfaction and 20-year mortality in healthy Finnish adults. , 2000, American journal of epidemiology.

[4]  E. Isometsä,et al.  Disability pension for major depression in Finland. , 2000, The American journal of psychiatry.

[5]  L. Judd,et al.  Does incomplete recovery from first lifetime major depressive episode herald a chronic course of illness? , 2000, The American journal of psychiatry.

[6]  W. Eaton,et al.  Psychopathology and the initiation of disability payments. , 2000, Psychiatric services.

[7]  John P. Rice,et al.  Psychosocial disability during the long-term course of unipolar major depressive disorder. , 2000, Archives of general psychiatry.

[8]  P. Allebeck,et al.  Psychosocial characteristics in young men as predictors of early disability pension with a psychiatric diagnosis , 1999, Social Psychiatry and Psychiatric Epidemiology.

[9]  A. Rissanen,et al.  Predictors of major weight gain in adult Finns: Stress, life satisfaction and personality traits , 1998, International Journal of Obesity.

[10]  W. Eaton,et al.  Psychopathology as a predictor of disability: a population-based follow-up study in Baltimore, Maryland. , 1998, American journal of epidemiology.

[11]  S. Saarijärvi,et al.  Depression and disability pension in Finland , 1997, Acta psychiatrica Scandinavica.

[12]  L. Niskanen,et al.  Correlates of life satisfaction among psychiatric patients , 1996, Acta psychiatrica Scandinavica.

[13]  K. Wells,et al.  Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. , 1996, The American journal of psychiatry.

[14]  M. Koskenvuo,et al.  Interpersonal conflict as a predictor of work disability: a follow-up study of 15,348 Finnish employees. , 1996, Journal of psychosomatic research.

[15]  J. Kaprio,et al.  Prevalence of diabetes, hypertension, and ischemic heart disease in former elite athletes. , 1994, Metabolism: clinical and experimental.

[16]  K. Wells,et al.  The course of depression in adult outpatients. Results from the Medical Outcomes Study. , 1992, Archives of general psychiatry.

[17]  L. George,et al.  Depression, disability days, and days lost from work in a prospective epidemiologic survey. , 1990, JAMA.

[18]  A. Stewart,et al.  Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. , 1989, JAMA.

[19]  A. Stewart,et al.  The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. , 1989, JAMA.

[20]  R. Honkanen,et al.  Self-reported life satisfaction and recovery from depression in a 1-year prospective study. , 2001, Acta psychiatrica Scandinavica.

[21]  L. Niskanen,et al.  Mental health at population level during an economic recession in Finland , 2000 .

[22]  A. Rissanen,et al.  A descriptive study of weight loss maintenance: 6 and 15 year follow-up of initially overweight adults , 2000, International Journal of Obesity.

[23]  C. Sherbourne,et al.  Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. , 1995, Archives of general psychiatry.

[24]  J Ormel,et al.  Common mental disorders and disability across cultures. Results from the WHO Collaborative Study on Psychological Problems in General Health Care. , 1994, JAMA.

[25]  William H. Rogers,et al.  Functional Status and Well-Being of Patients with Chronic Conditions , 1989 .

[26]  J. Kaprio,et al.  The Finnish Twin Registry: formation and compilation, questionnaire study, zygosity determination procedures, and research program. , 1978, Progress in clinical and biological research.

[27]  E. Saxén,et al.  Cancer in Finland 1953-1970: incidence, mortality, prevalence. , 1975, Acta pathologica et microbiologica Scandinavica. Supplement.