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The actions of the social insurance agency regarding long-term sickness absentees before and after a medical assessment--a study of 384 case files.

https://arctichealth.org/en/permalink/ahliterature271604
Source
Disabil Rehabil. 2015;37(18):1683-91
Publication Type
Article
Date
2015
Author
Staffan Marklund
Göran Lundh
Klas Gustafsson
Jürgen Linder
Pia Svedberg
Kristina Alexanderson
Source
Disabil Rehabil. 2015;37(18):1683-91
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Disability Evaluation
Female
Humans
Male
Middle Aged
Pensions
Rehabilitation, Vocational
Retrospective Studies
Return to work
Sick Leave
Social Work
Sweden
Work Capacity Evaluation
Young Adult
Abstract
The purpose of this article is to investigate actions taken by the Social Insurance Agency (SIA) for long-term sickness absentees and possible associations of this with future sick leave or disability pension.
For 384 long-term sickness absentees who had had a multidisciplinary medical assessment (MMA) during 2001-2006, three types of data were obtained: (1) case file information about SIA actions, (2) suggested rehabilitation measures from the MMA and (3) sickness absence and disability pension data.
Most individuals had been subject to a range of actions by the SIA. Sixty percent had been invited to a coordination meeting, and half of those who assessed by the MMA for vocational rehabilitation were approved to get it by the SIA. Few SIA actions were associated with full or partial return to work.
Although the studied individuals had been on sick leave for a long time, the number of SIA actions related to vocational rehabilitation was limited and came late in the sick-leave spell. The information from the MMA was often not used as a basis for further SIA action and seldom resulted in return to work. The positive MMA views on the potential of vocational rehabilitation were not met by SIA actions.
Suggestions on vocational rehabilitation from a medical assessment was in many cases not used by the social insurance agency in relationship to long-term sickness absentees. Active rehabilitation measures by the social insurance agency were few and came late in the sickness absence process. Few of the activities taken by the social insurance agency enhanced return to work.
PubMed ID
25354147 View in PubMed
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Adverse outcomes of sick leave due to mental disorders: A prospective study of discordant twin pairs.

https://arctichealth.org/en/permalink/ahliterature299213
Source
Scand J Public Health. 2019 Mar; 47(2):127-136
Publication Type
Journal Article
Date
Mar-2019
Author
Lisa Mather
Victoria Blom
Gunnar Bergström
Pia Svedberg
Author Affiliation
1 Division of Insurance Medicine, Karolinska Institutet, Sweden.
Source
Scand J Public Health. 2019 Mar; 47(2):127-136
Date
Mar-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Female
Humans
Male
Mental Disorders - epidemiology
Middle Aged
Prospective Studies
Sick Leave - statistics & numerical data
Sweden - epidemiology
Twins - psychology - statistics & numerical data
Young Adult
Abstract
The aim of this study was to investigate whether sick leave due to different mental disorders increased the risk of reoccurring sick-leave, disability pension and unemployment, taking genetics and shared environment into account.
This register-based cohort study contains 2202 discordant twin pairs 18-64 years old, where one twin had sick leave due to a mental disorder 2005-2006. The end of the sick-leave spell was the start of follow-up for both twins. The twins were followed up for reoccurring sick-leave, disability pension and unemployment (> 180 days in a year), until December 2012. Analyses were censored for disability pension, death, emigration and old-age pension. Cox proportional hazards models with time-varying covariates were used to calculate hazard ratios with 95% confidence intervals (CI).
Those with sick leave due to mental disorders had a 3.64 (CI: 3.24-4.08) times higher risk of reoccurring sick-leave within the first two years; after that, hazard ratios were attenuated and explained by genetic factors. The first year, they had 12.24 (CI: 8.11-18.46) times the risk of disability pension. The risk was attenuated but remained at 2.75 (CI: 2.07-3.65) after one year. The risk of unemployment was 1.99 (CI: 1.72-2.31) during the whole follow-up period. The risk of unemployment and disability pension was lower for those with stress-related than other mental disorders, this was less clear for recurrent reoccuring sick-leave.
Sick leave due to mental disorders increased the risk of reoccurring sick-leave within two years, disability pension and unemployment, independent of genetics and shared environment.
PubMed ID
29032743 View in PubMed
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An Underlying Common Factor, Influenced by Genetics and Unique Environment, Explains the Covariation Between Major Depressive Disorder, Generalized Anxiety Disorder, and Burnout: A Swedish Twin Study.

https://arctichealth.org/en/permalink/ahliterature286745
Source
Twin Res Hum Genet. 2016 Dec;19(6):619-627
Publication Type
Article
Date
Dec-2016
Author
Lisa Mather
Victoria Blom
Gunnar Bergström
Pia Svedberg
Source
Twin Res Hum Genet. 2016 Dec;19(6):619-627
Date
Dec-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anxiety Disorders - epidemiology - genetics - pathology
Burnout, Professional - epidemiology - genetics - pathology
Depressive Disorder, Major - epidemiology - genetics - pathology
Diseases in Twins - epidemiology - genetics - pathology
Environment
Female
Humans
Male
Middle Aged
Risk factors
Sweden
Twins, Dizygotic - genetics
Twins, Monozygotic - genetics
Young Adult
Abstract
Depression and anxiety are highly comorbid due to shared genetic risk factors, but less is known about whether burnout shares these risk factors. We aimed to examine whether the covariation between major depressive disorder (MDD), generalized anxiety disorder (GAD), and burnout is explained by common genetic and/or environmental factors. This cross-sectional study included 25,378 Swedish twins responding to a survey in 2005-2006. Structural equation models were used to analyze whether the trait variances and covariances were due to additive genetics, non-additive genetics, shared environment, and unique environment. Univariate analyses tested sex limitation models and multivariate analysis tested Cholesky, independent pathway, and common pathway models. The phenotypic correlations were 0.71 (0.69-0.74) between MDD and GAD, 0.58 (0.56-0.60) between MDD and burnout, and 0.53 (0.50-0.56) between GAD and burnout. Heritabilities were 45% for MDD, 49% for GAD, and 38% for burnout; no statistically significant sex differences were found. A common pathway model was chosen as the final model. The common factor was influenced by genetics (58%) and unique environment (42%), and explained 77% of the variation in MDD, 69% in GAD, and 44% in burnout. GAD and burnout had additive genetic factors unique to the phenotypes (11% each), while MDD did not. Unique environment explained 23% of the variability in MDD, 20% in GAD, and 45% in burnout. In conclusion, the covariation was explained by an underlying common factor, largely influenced by genetics. Burnout was to a large degree influenced by unique environmental factors not shared with MDD and GAD.
PubMed ID
27620693 View in PubMed
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Are self-report of disability pension and long-term sickness absence accurate? Comparisons of self-reported interview data with national register data in a Swedish twin cohort.

https://arctichealth.org/en/permalink/ahliterature138617
Source
BMC Public Health. 2010;10:763
Publication Type
Article
Date
2010
Author
Pia Svedberg
Annina Ropponen
Paul Lichtenstein
Kristina Alexanderson
Author Affiliation
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. pia.svedberg@ki.se
Source
BMC Public Health. 2010;10:763
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cross-Sectional Studies
Disabled Persons
Female
Humans
Insurance, Disability
Interviews as Topic
Male
Middle Aged
Pensions - statistics & numerical data
Registries
Reproducibility of Results
Sensitivity and specificity
Sick Leave - statistics & numerical data
Sweden
Universal Coverage
Abstract
Self-reported disability pension (DP) and sickness absence are commonly used in epidemiological and other studies as a measure of exposure or even as an outcome. The aims were (1) to compare such self-reports with national register information in order to evaluate the validity of self-reported DP and sickness absence, and (2) to estimate the concordance of reporting behaviour in different twin zygosity groups, also by sex.
All Swedish twins born 1933-1958 who participated in the Screening Across the Lifespan Twin study (SALT) 1998-2003, were included (31,122 individuals). The self-reported DP and long-term sickness absence (LTSA) at the time of interview was compared to the corresponding register information retrieved from the National Social Insurance Agency by calculating the proportions of agreements, kappa, sensitivity, specificity, concordance rates, and chi-square test, to evaluate construct validity.
The proportions of overall agreement were 96% and specificity 99% for both DP and LTSA, while the sensitivity was 70% for DP and 45% for LTSA. Kappa estimates were 0.76 for DP, and 0.58 for LTSA. The proportions of positive agreement were 64% for DP and 42% for LTSA. No difference in response style was found between zygosity groups among complete twin pairs for DP and LTSA. Results were similar for women and men and across age. Kappa estimates for DP differed somewhat depending on years of education, 0.68 (college/university) vs. 0.77 (less than 13 years in school) but not for LTSA.
Self-reported DP data may be very useful in studies when register information is not available, however, register data is preferred especially for LTSA. The same degree of twin similarity was found for truthful self-report of DP and LTSA in both monozygotic and dizygotic twin pairs. Thus, the response style was not influenced by genetic factors. One consequence of this would be that when estimating the relative importance of genetic and environmental effects from twin models, heritability estimates would not be biased.
Notes
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PubMed ID
21159191 View in PubMed
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Association between education and future leisure-time physical inactivity: a study of Finnish twins over a 35-year follow-up.

https://arctichealth.org/en/permalink/ahliterature284182
Source
BMC Public Health. 2016 Aug 04;16:720
Publication Type
Article
Date
Aug-04-2016
Author
Maarit Piirtola
Jaakko Kaprio
Urho M Kujala
Kauko Heikkilä
Markku Koskenvuo
Pia Svedberg
Karri Silventoinen
Annina Ropponen
Source
BMC Public Health. 2016 Aug 04;16:720
Date
Aug-04-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cross-Sectional Studies
Educational Status
Environment
Exercise
Family
Female
Finland
Follow-Up Studies
Health Behavior
Humans
Leisure Activities
Male
Middle Aged
Sedentary lifestyle
Social Environment
Surveys and Questionnaires
Twins
Young Adult
Abstract
Education is associated with health related lifestyle choices including leisure-time physical inactivity. However, the longitudinal associations between education and inactivity merit further studies. We investigated the association between education and leisure-time physical inactivity over a 35-year follow-up with four time points controlling for multiple covariates including familial confounding.
This study of the population-based Finnish Twin Cohort consisted of 5254 twin individuals born in 1945-1957 (59 % women), of which 1604 were complete same-sexed twin pairs. Data on leisure-time physical activity and multiple covariates was available from four surveys conducted in 1975, 1981, 1990 and 2011 (response rates 72 to 89 %). The association between years of education and leisure-time physical inactivity (
Notes
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PubMed ID
27492437 View in PubMed
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Association between long-term smoking and leisure-time physical inactivity: a cohort study among Finnish twins with a 35-year follow-up.

https://arctichealth.org/en/permalink/ahliterature294221
Source
Int J Public Health. 2017 Sep; 62(7):819-829
Publication Type
Journal Article
Twin Study
Date
Sep-2017
Author
Maarit Piirtola
Jaakko Kaprio
Karri Silventoinen
Pia Svedberg
Tellervo Korhonen
Annina Ropponen
Author Affiliation
Department of Public Health, University of Helsinki, P.O. Box 20/FIMM (Tukholmankatu 8, 2B), 00014, Helsinki, Finland. maarit.piirtola@helsinki.fi.
Source
Int J Public Health. 2017 Sep; 62(7):819-829
Date
Sep-2017
Language
English
Publication Type
Journal Article
Twin Study
Keywords
Adolescent
Adult
Aged
Female
Finland - epidemiology
Follow-Up Studies
Humans
Leisure Activities
Male
Middle Aged
Sedentary lifestyle
Smoking - epidemiology - psychology
Surveys and Questionnaires
Twins - psychology - statistics & numerical data
Young Adult
Abstract
To investigate longitudinal associations of smoking and a change in smoking status with leisure-time physical inactivity. In addition, to control whether familial confounding (genetics and shared environment) influences the associations.
Data were based on the population-based Finnish Adult Twin Cohort of 5254 twin individuals born in 1945-1957 (41% men) and who participated in all four surveys over a 35-year follow-up (1975-2011). Logistic and conditional logistic regression models with multiple covariates were used for analyses.
Compared to never-smokers, long-term daily smokers (1975-1990) had the highest likelihood for both long-term inactivity and to change into inactive by 2011. Recurrent smoking was associated with long-term inactivity. Instead, in comparison to persistent daily smokers, quitting smoking decreased the likelihood of becoming physically inactive at leisure time. The associations remained in the analyses which accounted for multiple covariates and/or familial confounding.
Daily smoking increases the likelihood of remaining or becoming physically inactive over the decades. Our results emphasize not only the importance of preventing smoking initiation, but also to support early smoking cessation in promotion of lifelong physical activity.
Notes
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PubMed ID
28488098 View in PubMed
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Associations between childbirth, hospitalization and disability pension: a cohort study of female twins.

https://arctichealth.org/en/permalink/ahliterature260802
Source
PLoS One. 2014;9(7):e101566
Publication Type
Article
Date
2014
Author
Emma Björkenstam
Jurgita Narusyte
Kristina Alexanderson
Annina Ropponen
Linnea Kjeldgård
Pia Svedberg
Source
PLoS One. 2014;9(7):e101566
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cohort Studies
Disabled persons - statistics & numerical data
Family
Female
Hospitalization - statistics & numerical data
Humans
Middle Aged
Parturition
Pensions - statistics & numerical data
Pregnancy
Risk
Sweden - epidemiology
Young Adult
Abstract
As the literature on long-term effects of childbirth on risk of morbidity or permanent work incapacity (DP) is limited, we aimed to study associations of childbirth with hospitalization and DP, adjusting for familial factors.
This cohort study included female twins, i.e. women with twin sister, born 1959-1990 in Sweden (n?=?5 118). At least one in the twin pair had their first childbirth 1994-2009. Women were followed regarding all-cause and cause-specific (mental or musculoskeletal diagnoses) DP during year 2-5 after first delivery or equivalent. Associations between childbirth, hospitalization and DP were calculated as hazard ratios (HR) with 95% confidence intervals (CI).
Women who did not give birth had markedly higher number of DP days/year compared to those giving birth. Hospitalization after first childbirth was associated with a higher HR of DP. Those hospitalized at least once after their first childbirth had a three-fold DP risk (HR: 3.2; 95% CI 1.1-9.6), DP due to mental diagnoses (HR: 3.2; 1.2-8.8), and of DP due to musculoskeletal diagnoses (HR: 6.1; 1.6-22.9). Lower HRs in the discordant twin pair analyses indicated that familial factors may influence the studied associations.
Women who did not give birth had a much higher risk for DP than those who did. Among those who gave birth, the risk for DP was markedly higher among those with a previous hospitalization, and especially in women with repeated hospitalizations. The results indicate a health selection into giving birth as well as the importance of morbidity for DP.
Notes
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PubMed ID
24999632 View in PubMed
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Associations between prognosed future work capacity among long-term sickness absentees and their actual work incapacity two years later.

https://arctichealth.org/en/permalink/ahliterature276711
Source
Work. 2014;49(2):245-55
Publication Type
Article
Date
2014
Author
Göran Lundh
Klas Gustafsson
Jürgen Linder
Pia Svedberg
Kristina Alexanderson
Staffan Marklund
Source
Work. 2014;49(2):245-55
Date
2014
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Disability Evaluation
Disabled persons - statistics & numerical data
Female
Humans
Illness Behavior
Male
Middle Aged
Prognosis
Return to Work - statistics & numerical data
Sick Leave - statistics & numerical data
Sweden
Work Capacity Evaluation
Abstract
Studies indicate that long-term sickness absence reduces the ability to return to work (RTW). Multidisciplinary medical assessments (MMA) have been used as a method to receive a more versatile assessment of long-term sickness absentees (LTSA) and thereby a better basis for adequate medical and vocational rehabilitation, and an increasing ability to maintain or regain work capacity.
The objective of this study was to investigate the associations between the prognoses of LTSAs' future work capacity made at a MMA and the assessments of their work incapacity made by the Social Insurance Offices (SIO) two years later.
385 LTSAs referred to an MMA by SIOs in the Stockholm area in Sweden between 2001 and 2006.
Data was collected at the MMA on demographic factors, health, diagnoses, and future work capacity. Information on SIO decisions on sickness benefits and disability pension and what measures the SIO had taken was extracted from the case files at the SIOs. Descriptive statistics and multiple regression analyses were used to assess the associations between the prognosis and decisions on benefits, controlling for individual factors.
Of those predicted to be able to maintain or regain work capacity, 68% received full-time benefits two years later. Work capacity was negatively affected by high age, full time sickness absence at MMA and number of physical symptoms at MMA. The prognosis at the MMA was not significantly related to work capacity when socio-demographic and health factors were controlled for. However, this was partly due to the fact that the MMA also included recommendations for vocational rehabilitation and that this factor had an effect on assessed work incapacity after two years.
The prognosis of future work capacity evaluated at a multidisciplinary medical assessment correlated with actual work capacity two years later. However, a range of other factors were decisive for the result. The study shows that the link between the prognosis and recommendations for vocational rehabilitation should be followed by the SIOs responsible for enhancing RTW among individuals on long-term sick leave.
PubMed ID
24004785 View in PubMed
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Associations between scores of psychosomatic health symptoms and health-related quality of life in children and adolescents.

https://arctichealth.org/en/permalink/ahliterature106545
Source
Health Qual Life Outcomes. 2013;11:176
Publication Type
Article
Date
2013
Author
Pia Svedberg
Mårten Eriksson
Eva Boman
Author Affiliation
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. pia.svedberg@ki.se.
Source
Health Qual Life Outcomes. 2013;11:176
Date
2013
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Cross-Sectional Studies
Female
Health status
Humans
Male
Psychophysiologic Disorders - epidemiology - psychology
Quality of Life
Questionnaires
Sweden - epidemiology
Abstract
The aims of the present study are to investigate whether there are differences in health-related quality of life (HRQoL) between girls and boys in two different age groups, to study how much of children's variance in HRQoL can be explained by common psychosomatic health symptoms, and to examine whether the same set of psychosomatic symptoms can explain differences in HRQoL, both between girls and boys and between older and younger school children.
A cross-sectional study was conducted of 253 children, 99 of ages 11-12 years (n=51 girls, n=48 boys) and 154 of ages 15-16 years (n=82 girls, n=72 boys), in Swedish schools. The KIDSCREEN-52 instrument, which covers 10 dimensions of HRQoL and additional questions about psychosomatic health symptoms, were used. Analyses of variance were conducted to investigate differences between the genders and age groups, and in interaction effects on the KIDSCREEN-52 dimensions. Regression analyses were used to investigate the impacts of psychosomatic symptoms on gender and age group differences in HRQoL.
Boys rated themselves higher than girls on the KIDSCREEN dimensions: physical and psychological well-being, moods and emotions, self-perception, and autonomy. Main effects of age group were found for physical well-being, psychological well-being, moods and emotions, self-perception, autonomy, and school environment, where younger children rated their HRQoL more highly than those aged 15-16 years. Girls rated their moods and emotions dramatically lower than boys in the older age group, but the ratings of emotional status were more similar between genders at younger ages. Psychosomatic symptoms explained between 27% and 50% of the variance in the children's HRQoL. Sleeping difficulties were a common problem for both girls and boys. Depression and concentration difficulties were particularly associated with HRQoL among girls whereas stomach aches were associated with HRQoL among boys.
Girls and adolescents experience poorer HRQoL than boys and younger children, but having psychosomatic symptoms seem to explain a substantial part of the variation. Strategies to promote health among school children, in particular to alleviate sleep problems among all children, depression and concentration difficulties among girls, and stomach aches among boys, are of great importance.
Notes
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PubMed ID
24148880 View in PubMed
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Associations between sickness absence and harassment, threats, violence, or discrimination: a cross-sectional study of the Swedish Police.

https://arctichealth.org/en/permalink/ahliterature124022
Source
Work. 2012;42(1):83-92
Publication Type
Article
Date
2012
Author
Pia Svedberg
Kristina Alexanderson
Author Affiliation
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Pia.Svedberg@ki.se
Source
Work. 2012;42(1):83-92
Date
2012
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Age Distribution
Bullying - psychology
Cross-Sectional Studies
Dominance-Subordination
Employment - psychology - statistics & numerical data
Female
Humans
Interprofessional Relations
Male
Middle Aged
Occupational Diseases - etiology
Occupations - statistics & numerical data
Police
Prejudice
Questionnaires
Sex Distribution
Sexual Harassment - psychology - statistics & numerical data
Sick Leave - statistics & numerical data - trends
Social Behavior
Sweden - epidemiology
Violence - psychology - statistics & numerical data - trends
Workplace - psychology
Abstract
To study if sick leave among employees in the Swedish Police was associated with experiences of discrimination, harassment, or (threats of) violence.
All employees in the Swedish Police in 2005.
Analyses of data from a questionnaire to all employees; 74% (n=16,725) responded. Odds ratios (OR) with 95% confidence intervals (CI) between sick leave and the studied factors were assessed.
The rate of sickness absence was higher for women (12%) than for men (8%) (p
PubMed ID
22635152 View in PubMed
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