Risk and risk factors for disability pension among patients with treatment resistant depression– a matched cohort study
Abstract Background Treatment resistant depression (TRD) is common among patients with depression, and is associated with clinical and functional disability. However, the risk and risk factors for being granted disability pension (DP) among patients with TRD have not been investigated. Methods All a...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Psychiatry |
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| Online Access: | http://link.springer.com/article/10.1186/s12888-020-02642-9 |
| _version_ | 1811210397570564096 |
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| author | Heidi Taipale Johan Reutfors Antti Tanskanen Lena Brandt Jari Tiihonen Allitia DiBernardo Ellenor Mittendorfer-Rutz Philip Brenner |
| author_facet | Heidi Taipale Johan Reutfors Antti Tanskanen Lena Brandt Jari Tiihonen Allitia DiBernardo Ellenor Mittendorfer-Rutz Philip Brenner |
| author_sort | Heidi Taipale |
| collection | DOAJ |
| description | Abstract Background Treatment resistant depression (TRD) is common among patients with depression, and is associated with clinical and functional disability. However, the risk and risk factors for being granted disability pension (DP) among patients with TRD have not been investigated. Methods All antidepressant initiators in Sweden with a diagnosis of depression in specialized care were identified in nationwide registers 2006–2013 and followed regarding treatment trials. TRD was defined as the start of a third sequential trial. Patients with TRD who were not on DP (N = 3204) were matched by age, sex, history of depression, calendar year, and time for treatment start with 3204 comparators with depression and ongoing antidepressant treatment. A proportional Cox Regression was performed with DP as outcome, adjusted for various sociodemographic and clinical covariates. Results Compared to the comparison cohort, TRD was associated with a doubled risk for all-cause DP (aHR 2.07; 95%CI 1.83–2.35), DP due to depression (2.28; 1.82–2.85) and to any mental disorder (2.24; 1.95–2.57) but not due to somatic diagnoses (1.25; 0.84–1.86). Among significant risk factors for DP in TRD were female sex, being > 29 years of age, unemployment and a diagnosis of comorbid personality disorder (ICD-10 codes F60.0–9). Conclusion TRD is associated with an elevated risk for DP compared to other patients with depression, with large potential costs for the affected patients and for society. Clinical and therapeutic implications for patients with TRD who are granted DP should be further investigated. Limitation: No clinical data, e.g. type of depression or reason for treatment switch, was available for this study. |
| first_indexed | 2024-04-12T04:54:54Z |
| format | Article |
| id | doaj.art-9388eb74b97c4f7e8da29fe7cd78c5f7 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-12T04:54:54Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-9388eb74b97c4f7e8da29fe7cd78c5f72022-12-22T03:47:10ZengBMCBMC Psychiatry1471-244X2020-05-0120111110.1186/s12888-020-02642-9Risk and risk factors for disability pension among patients with treatment resistant depression– a matched cohort studyHeidi Taipale0Johan Reutfors1Antti Tanskanen2Lena Brandt3Jari Tiihonen4Allitia DiBernardo5Ellenor Mittendorfer-Rutz6Philip Brenner7Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska InstitutetCentre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University HospitalDepartment of Clinical Neuroscience, Division of Insurance Medicine, Karolinska InstitutetCentre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University HospitalDepartment of Clinical Neuroscience, Division of Insurance Medicine, Karolinska InstitutetJanssen Research & Development, LLCDepartment of Clinical Neuroscience, Division of Insurance Medicine, Karolinska InstitutetCentre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University HospitalAbstract Background Treatment resistant depression (TRD) is common among patients with depression, and is associated with clinical and functional disability. However, the risk and risk factors for being granted disability pension (DP) among patients with TRD have not been investigated. Methods All antidepressant initiators in Sweden with a diagnosis of depression in specialized care were identified in nationwide registers 2006–2013 and followed regarding treatment trials. TRD was defined as the start of a third sequential trial. Patients with TRD who were not on DP (N = 3204) were matched by age, sex, history of depression, calendar year, and time for treatment start with 3204 comparators with depression and ongoing antidepressant treatment. A proportional Cox Regression was performed with DP as outcome, adjusted for various sociodemographic and clinical covariates. Results Compared to the comparison cohort, TRD was associated with a doubled risk for all-cause DP (aHR 2.07; 95%CI 1.83–2.35), DP due to depression (2.28; 1.82–2.85) and to any mental disorder (2.24; 1.95–2.57) but not due to somatic diagnoses (1.25; 0.84–1.86). Among significant risk factors for DP in TRD were female sex, being > 29 years of age, unemployment and a diagnosis of comorbid personality disorder (ICD-10 codes F60.0–9). Conclusion TRD is associated with an elevated risk for DP compared to other patients with depression, with large potential costs for the affected patients and for society. Clinical and therapeutic implications for patients with TRD who are granted DP should be further investigated. Limitation: No clinical data, e.g. type of depression or reason for treatment switch, was available for this study.http://link.springer.com/article/10.1186/s12888-020-02642-9Major depressive disorderDisability pensionTreatment resistant depressionEpidemiologyAntidepressants |
| spellingShingle | Heidi Taipale Johan Reutfors Antti Tanskanen Lena Brandt Jari Tiihonen Allitia DiBernardo Ellenor Mittendorfer-Rutz Philip Brenner Risk and risk factors for disability pension among patients with treatment resistant depression– a matched cohort study BMC Psychiatry Major depressive disorder Disability pension Treatment resistant depression Epidemiology Antidepressants |
| title | Risk and risk factors for disability pension among patients with treatment resistant depression– a matched cohort study |
| title_full | Risk and risk factors for disability pension among patients with treatment resistant depression– a matched cohort study |
| title_fullStr | Risk and risk factors for disability pension among patients with treatment resistant depression– a matched cohort study |
| title_full_unstemmed | Risk and risk factors for disability pension among patients with treatment resistant depression– a matched cohort study |
| title_short | Risk and risk factors for disability pension among patients with treatment resistant depression– a matched cohort study |
| title_sort | risk and risk factors for disability pension among patients with treatment resistant depression a matched cohort study |
| topic | Major depressive disorder Disability pension Treatment resistant depression Epidemiology Antidepressants |
| url | http://link.springer.com/article/10.1186/s12888-020-02642-9 |
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