Potentially traumatic events as predictors of disability pension: A 10-year follow-up study in Norway

Abstract

Aims: Are potentially traumatic events associated with subsequent disability pension? Traumatic exposure and post-traumatic stress disorder (PTSD) may represent a disabling state with both personal and professional consequences for the affected individual. Despite this, there is a scarcity of research studying the effects of traumatic exposure on disability pension. This study examined the differences in risk for disability pension among unexposed, exposed to trauma and PTSD cases. Methods: An ambidirectional Norwegian cohort study, consisting of 1238 individuals aged 18–66 years who were at risk of disability pension, were interviewed using the Composite International Diagnostic Interview, and linked with registry data on disability pension. Registry follow-up in the Norwegian Insurance Database lasted ten years following interview in 2000–01. The risk of disability pension after traumatic exposure, divided into accidental and premeditated, was assessed by Cox proportional hazards regression analysis. Results: In 10 years, 9.5% of the cohort had been granted disability pension. Overall exposure to traumatic events did not alter the risk of disability pension. However, among women, exposure to premeditated traumas did increase the risk (HR 2.96 (95% CI 1.54–5.68)), and was an independent risk factor. Fulfilling criteria for PTSD caseness further increased the risk (HR 4.69 (95% CI 1.78–12.40)). There was no increased risk found between traumatic exposure and disability pension for men. Conclusions: Exposure to trauma, particularly premeditated trauma, seems to be an independent risk factor for disability pension in women.