There is limited information regarding the association between youth mental health problems and work incapacity in adulthood. We investigated whether internalizing (depressive, anxious, somatic complaints) and externalizing (aggressive, rule-breaking) behavior problems in childhood and adolescence were associated with sickness absence (SA) and disability pension (DP) in young adulthood.
Data were used from the population-based and prospective Twin Study of Child and Adolescent Development (TCHAD) which includes all Swedish twins born in 1985–1986 (N = 2570). Internalizing and externalizing behavior problems were assessed with the Child Behavior Checklist at ages of 8–9, 13–14, 16–17, and 19–20 years. Individuals participating in TCHAD were followed regarding SA and DP during 2001–2013 using nationwide registers. Cox regression models were applied to assess hazard ratios (HR) with 95% confidence intervals (CI).
Each one-unit increase of rule-breaking behavior implied a significant higher risk for SA in early adulthood, despite of age at assessment, with the highest HR of 1.12 (95% CI 1.05–1.19) at age of 8–9 years. Higher levels of anxious and depressive symptoms in childhood and adolescence were associated with DP in early adulthood despite age at assessment, with the highest risk at age 19–20 years [HR 1.31 (95% CI 1.12–1.53)]. The associations attenuated slightly when familial factors were taken into account.
Internalizing and externalizing behavior problems identified at an early age (8–9 years) increased risk for SA and DP in young adulthood. These findings indicate that early prevention and intervention efforts to reduce behavior problems may promote a successful start in working life.
OECD (2009) Sickness, disability and work: keeping on track in the economic downturn—background paper for the high-level forum in May 2009. OECD, Paris
Swedish Social Insurance Agency (2015) Social insurance in figures 2015. Swedish Social Insurance Agency, Stockholm, Sweden
OECD (2013) Mental health and work. OECD Publishing, Sweden
Lichtenstein P, Tuvblad C, Larsson H et al (2007) The Swedish Twin study of CHild and Adolescent Development: the TCHAD-study. Twin Res Hum Gene 10(1):67–73 CrossRef
Achenbach TM, Rescorla LA (2000) Manual for ASEBA school-age forms & profiles. University of Vermont, Research Center for Children, Youth, and Families, Burlington
McGue M, Osler M, Christensen K (2010) Causal inference and observational research: the utility of twins. Perspect Psychol Sci J Assoc Psychol Sci 5(5):546–556 (Epub 2011/05/20) CrossRef
SAS Institute Inc (2013) The SAS system, Version 9.4. SAS Institute Inc, Cary
Mordre M, Groholt B, Sandstad B et al (2012) The impact of ADHD symptoms and global impairment in childhood on working disability in mid-adulthood: a 28-year follow-up study using official disability pension records in a high-risk in-patient population. BMC Psychiatry 12:174 (Epub 2012/10/23) CrossRefPubMedPubMedCentral
Jonsson U, Mittendorfer-Rutz E, Kjeldgard L et al (2013) Unga vuxna med aktivitetsersättning—risk för suicidförsök och suicid. Statens Offentliga Utredningar, Stockholm
Torvik FA, Gjerde LC, Røysamb E, Tambs K, Kendler KS, Czajkowski NO, Knudsen GP, Reichborn-Kjennerud T, Ørstavik RE (2014) Genetic and environmental contributions to the relationship between internalizing disorders and sick leave granted for mental and somatic disorders. Twin Res Hum Genet 17(4):225–235 (Epub 2014/05/16)
Angold A, Rutter M (1992) Effects of age and pubertal status on depression in a large clinical sample. Dev Psychopathol 4:5–28 CrossRef
Allebeck P, Mastekaasa A (2004) Risk factors for sick leave—general studies. Scand J Publ Health 32(Supplement 63):49–108 CrossRef
- Internalizing and externalizing problems in childhood and adolescence as predictors of work incapacity in young adulthood
- Springer Berlin Heidelberg