DOES PSYCHOLOGICAL DISTRESS PREDICT DISABILITY

Study Objective. To evaluate psychological distress as a predictor of disability due to common chronic disorders, Study Population and Metho ds. A 10-year follow-up study was carried out among a representative c ohort (N = 8655) of 18-64 year old Finnish farmers, who had participat ed in a health survey in 1979 and were able to work at baseline, A rec ord linkage with the nationwide register of the Social Insurance Insti tution was made to identify disability pensions granted between 1980 a nd 1990 in the cohort. The medical certificates of 1004 (11.6%) premat urely retired farmers were reviewed to confirm and classify disabling conditions. A sum score based on self-reports of 11 symptoms at the ba seline was used as a measure of psychological distress. Results. After adjustment for age, sex, smoking and body mass index, the cause-speci fic relative risks (RR) (95% confidence intervals [CI]) of disability in the highest quartile of the psychological distress score as compare d with the lowest quartile were for myocardial infarction 2.34 (95% CI :1.17-4.69), for depression 2.50 (95% CI:1.09-5.72), for neck-shoulde r disorders 1.98 (95% CI : 1.26-3.11), for unspecified low-back disord ers 1.76 (95% CI : 1.24-2.49), for knee osteoarthritis 1.55 (95% CI : 0.91-2.63) and for hip osteoarthritis 0.89 (95% CI : 0.42-1.85). The c orresponding RR for overall disability was 1.76 (95% CI : 1.44-2.14) i n the highest quartile of psychological distress score as compared wit h the lowest quartile. Conclusions. Psychological distress is an indep endent risk factor for disability. Its predictive significance varies between disorders leading to functional deterioration. The association mechanisms are likely to vary from one disorder to another.