Abstract
BackgroundDespite high rates of youth suicide attempt, little is known about patterns of functional impairment in terms of sickness absence and disability pension (SA/DP) before and after an attempt. The aim was to identify SA/DP trajectories among young adults with or without suicide attempt and to describe associations of socio-demographic and clinical factors with such trajectories.MethodsThis is a population-based cohort study of 5385 individuals aged 25–40 years with a first suicide attempt during 2007–2009. One control for each case without suicide attempt was matched by socio-demographic factors. Trajectories of annual SA/DP months over an eight-year period were analysed by group-based trajectory modelling. Associations between socio-demographic and clinical factors with trajectory groups were estimated by chi2-test and multinomial logistic regression.ResultsTwo groups of suicide attempters had low SA/DP levels over time (62%). One group had constantly high SA/DP levels (16%). The remaining two groups had increased SA/DP initially, which then decreased at different time points. Socio-demographic and clinical factors were associated with different trajectories (R2 = 0.44). Suicide attempters with low levels of SA/DP were likely to be unemployed whereas a larger proportion of those with high levels of SA/DP had psychiatric health care before the suicide attempt, particularly due to schizophrenia and non-affective psychoses or personality disorders.ConclusionsYoung suicide attempters even with no/low levels of SA/DP were likely to be marginalised at the labour market. Schizophrenia/non-affective psychoses and personality disorders were important clinical factors for differentiating the levels of SA/DP among young suicide attempters.
Highlights
Despite high rates of youth suicide attempt, little is known about patterns of functional impairment in terms of sickness absence and disability pension (SA/Disability pension (DP)) before and after an attempt
Despite the evidence related to the interlinked relationship between suicide attempt and Sickness absence (SA)/DP, only a few studies have investigated the association between sickness absence and disability pension (SA/DP) and suicide attempt in the general population and in individuals with depressive disorders [6,7,8,9]
Main findings In this study, five different trajectories of SA/DP were identified over an 8-year period among all 5385 young individuals with a first suicide attempt treated in inpatient care during 2007–2009 in Sweden
Summary
Despite high rates of youth suicide attempt, little is known about patterns of functional impairment in terms of sickness absence and disability pension (SA/DP) before and after an attempt. Young people with suicide attempt are likely to repeat this behaviour and have an increased risk for subsequent mortality due to suicide [2]. The long-term risk of functional impairment is increased in young suicide attempters, impairment related. Despite the evidence related to the interlinked relationship between suicide attempt and SA/DP, only a few studies have investigated the association between SA/DP and suicide attempt in the general population and in individuals with depressive disorders [6,7,8,9]. When studying such associations, it needs to be considered that suicide attempters comprise a heterogeneous group in terms of aetiology, intent, sociodemographic characteristics, clinical factors such as severity of underlying mental and somatic diseases, psychosocial factors, as well as healthcare seeking behaviour [2]. A comparison with individuals without suicide attempt can provide important insights in peculiarities of SA/DP trajectories in young suicide attempters
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