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Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters

BACKGROUND: Individuals with a history of suicide attempt have a high risk for subsequent labour market marginalization. This study aimed at assessing the effect of individual and parental factors on different measures of marginalization. METHODS: Prospective cohort study based on register linkage o...

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Autores principales: Niederkrotenthaler, Thomas, Tinghög, Petter, Goldman-Mellor, Sidra, Wilcox, Holly C., Gould, Madelyn, Mittendorfer-Rutz, Ellenor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718648/
https://www.ncbi.nlm.nih.gov/pubmed/26784886
http://dx.doi.org/10.1371/journal.pone.0146130
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author Niederkrotenthaler, Thomas
Tinghög, Petter
Goldman-Mellor, Sidra
Wilcox, Holly C.
Gould, Madelyn
Mittendorfer-Rutz, Ellenor
author_facet Niederkrotenthaler, Thomas
Tinghög, Petter
Goldman-Mellor, Sidra
Wilcox, Holly C.
Gould, Madelyn
Mittendorfer-Rutz, Ellenor
author_sort Niederkrotenthaler, Thomas
collection PubMed
description BACKGROUND: Individuals with a history of suicide attempt have a high risk for subsequent labour market marginalization. This study aimed at assessing the effect of individual and parental factors on different measures of marginalization. METHODS: Prospective cohort study based on register linkage of 5 649 individuals who in 1994 were 16–30 years old, lived in Sweden and were treated in inpatient care for suicide attempt during 1992–1994. Hazard ratios (HRs) for labour market marginalization defined as long-term unemployment (>180 days), sickness absence (>90 days), or disability pension in 1995–2010 were calculated with Cox regression. RESULTS: Medical risk factors, particularly any earlier diagnosed specific mental disorders (e.g., schizophrenia: HR 5.4 (95% CI: 4.2, 7.0), personality disorders: HR 3.9, 95% CI: 3.1, 4.9), repetitive suicide attempts (HR 1.6, 95% CI: 1.4, 1.9) were associated with a higher relative risk of disability pension. Individual medical factors were of smaller importance for long-term sickness absence, and of only marginal relevance to long-term unemployment. Country of birth outside Europe had an opposite effect on disability pension (HR 0.6, 95% CI: 0.4, 0.8) and long-term unemployment (HR 1.5, 95% CI: 1.3, 1.8). Female sex was positively correlated with long-term sickness absence (HR 1.6, 95% CI: 1.4, 1.7), and negatively associated with long-term unemployment (HR: 0.8, 95% CI: 0.7, 0.9). CONCLUSIONS: As compared to disability pension, long-term sickness absence and unemployment was more strongly related to socio-economic variables. Marginalization pathways seemed to vary with migration status and sex. These findings may contribute to the development of intervention strategies which take the individual risk for marginalization into account.
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spelling pubmed-47186482016-01-30 Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters Niederkrotenthaler, Thomas Tinghög, Petter Goldman-Mellor, Sidra Wilcox, Holly C. Gould, Madelyn Mittendorfer-Rutz, Ellenor PLoS One Research Article BACKGROUND: Individuals with a history of suicide attempt have a high risk for subsequent labour market marginalization. This study aimed at assessing the effect of individual and parental factors on different measures of marginalization. METHODS: Prospective cohort study based on register linkage of 5 649 individuals who in 1994 were 16–30 years old, lived in Sweden and were treated in inpatient care for suicide attempt during 1992–1994. Hazard ratios (HRs) for labour market marginalization defined as long-term unemployment (>180 days), sickness absence (>90 days), or disability pension in 1995–2010 were calculated with Cox regression. RESULTS: Medical risk factors, particularly any earlier diagnosed specific mental disorders (e.g., schizophrenia: HR 5.4 (95% CI: 4.2, 7.0), personality disorders: HR 3.9, 95% CI: 3.1, 4.9), repetitive suicide attempts (HR 1.6, 95% CI: 1.4, 1.9) were associated with a higher relative risk of disability pension. Individual medical factors were of smaller importance for long-term sickness absence, and of only marginal relevance to long-term unemployment. Country of birth outside Europe had an opposite effect on disability pension (HR 0.6, 95% CI: 0.4, 0.8) and long-term unemployment (HR 1.5, 95% CI: 1.3, 1.8). Female sex was positively correlated with long-term sickness absence (HR 1.6, 95% CI: 1.4, 1.7), and negatively associated with long-term unemployment (HR: 0.8, 95% CI: 0.7, 0.9). CONCLUSIONS: As compared to disability pension, long-term sickness absence and unemployment was more strongly related to socio-economic variables. Marginalization pathways seemed to vary with migration status and sex. These findings may contribute to the development of intervention strategies which take the individual risk for marginalization into account. Public Library of Science 2016-01-19 /pmc/articles/PMC4718648/ /pubmed/26784886 http://dx.doi.org/10.1371/journal.pone.0146130 Text en © 2016 Niederkrotenthaler et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Niederkrotenthaler, Thomas
Tinghög, Petter
Goldman-Mellor, Sidra
Wilcox, Holly C.
Gould, Madelyn
Mittendorfer-Rutz, Ellenor
Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters
title Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters
title_full Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters
title_fullStr Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters
title_full_unstemmed Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters
title_short Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters
title_sort medical and social determinants of subsequent labour market marginalization in young hospitalized suicide attempters
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718648/
https://www.ncbi.nlm.nih.gov/pubmed/26784886
http://dx.doi.org/10.1371/journal.pone.0146130
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