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J Affect Disord. 2014 Aug;165:38-44. doi: 10.1016/j.jad.2014.04.036. Epub 2014 Apr 23.

Common mental and musculoskeletal disorders as predictors of disability retirement among Finns.

Author information

Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland. Electronic address:
Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.
Department of Health Sciences, University of Tampere, Finland.
Centre of Expertise for Work Organisations, Finnish Institute of Occupational Health, Helsinki, Finland.
Creating Solutions, Statistics and Health Economics Team, Finnish Institute of Occupational Health, Helsinki, Finland.
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland.



The contribution of common mental disorders (CMD) co-occurring with chronic musculoskeletal disorders (MSD) to disability retirement is not known.


A nationally representative sample (the Health 2000 survey) comprised 3943 occupationally active Finns aged 30-63. MSD and other chronic disorders were assessed by a physician in a standardized clinical examination, and CMD using the Composite International Diagnostic Interview. Disability pension data for 2000-2011 was retrieved from national pension records. Cox regression was used with censoring for death and pension other than that for disability. Covariate information was based on an interview.


The baseline prevalence of CMD was 9.4% and of MSD 31.1%. CMD co-occurred with MSD in 3.3% of participants. The risks inflicted by CMD and MSD were additive. Thirty-eight per cent of the co-morbid subjects, 18% of those with CMD and 19% of those with MSD retired prematurely during the average follow-up of 8.6 years. Compared with those with neither type of disorder, the hazard ratio (HR) for disability pension was 2.4 (95% CI 1.7-2.7) for CMD only, 2.2 (1.8-2.7) for MSD only, and 4.1 (2.9-5.7) for the occurrence of both, allowing for age, gender, other chronic disorders, working conditions, and socio-economic and lifestyle factors. No synergistic or antagonistic interactive effects were observed.


The determinants were measured only once and we had no information on incident disorders during the follow-up.


It is important to identify subjects with both mental and musculoskeletal complaints in order to efficiently support their work ability.


Disability retirement; Mental health; Musculoskeletal disorders

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