Work incapacity and psychiatric patient care following attempted suicide – a cohort study of 65 097 Swedish twins
- Type :#article
- Date read: 2023-07-21
- Bibtex: @lindberg2023
- Bibliography: Lindberg, A., Svedberg, P., Ropponen, A., Narusyte, J., & Wang, M. (2023). Work incapacity and psychiatric patient care following attempted suicide – a cohort study of 65 097 Swedish twins. Psychological Medicine, 53(8), 3728–3734. https://doi.org/10.1017/S0033291722000435
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- Increased risk of sickness absence (HR = 1.24), disability pension (HR = 1.81), and psychiatric care (HR = 2.48) in 2007-2013 after suicide attempt between 1998-2006.
This was as expected given the close connection between suicidal behavior and poor mental health (Hawton & van Heeringen, 2009). However, our results were controlled also for previous common mental disorders and prescribed psychiatric medication, which might have underlined the association between suicide attempt and mental health. Furthermore, results of the analyses accounting the baseline mental health status (i.e. those who had received psychiatric care before 2007 and those who had not) did not show a substantial difference in HRs. Only in DZ twins, individuals who had received previous psychiatric care had a somewhat higher risk of future mental disorders compared to those without previous psychiatric care.
The results of this study suggest that there might be unrecovered or undetected underlying mental disorders of individuals who are known to have attempted suicide, since they still have a higher risk for future mental diagnoses after being treated. Previous research suggests that only around 30% of individuals with mental disorders visit health care (Appleby et al., 2017) and thus it is likely that unrecognized mental disorder underlies the association of suicide attempt and future mental disorders.
Abstract
Background Research is scarce on the role of familial factors and previous psychiatric care on the association between suicide attempt and future work incapacity as well as deterioration in mental health. We aimed to investigate the associations between suicide attempt and sickness absence, disability pension and psychiatric patient care and to study the influence of previous psychiatric care and familial factors (genetics and shared environment) on the associations.
Methods The study included 65 097 twins living in Sweden on 31st of December 2006, aged 19–60 years. The twins were followed 2007–2013 regarding sickness absence, disability pension, inpatient care or specialized outpatient care for a mental diagnosis. Cox regression models were performed for the whole sample, and conditional models for discordant twin pairs. The analyses were also stratified by psychiatric care before 2007.
Results We found that suicide attempt predicted sickness absence, disability pension, and future mental diagnosis among the whole sample. The discordant twin pair analyses showed that the association between suicide attempt and sickness absence or disability pension was influenced by familial factors. Stratified analyses of individuals with or without psychiatric care before 2007 showed that previous psychiatric care had some impact on the associations.
Conclusions A suicide attempt is a risk factor for work incapacity and psychiatric patient care. Familial factors and previous psychiatric care play a role in the associations between attempting suicide and work incapacity as well as psychiatric patient care. These factors are important when developing measures preventing work incapacity among those with a suicide attempt. PDF: lindberg_2023_work_incapacity_and_psychiatric_patient_care_following_attempted_suicide_–_a.pdf