Alcohol consumption, problem drinking, abstention and disability pension award. The Nord-Trøndelag Health Study (HUNT)

Authors

  • Jens Christoffer Skogen,

    Corresponding author
    1. Mental Health Epidemiology, Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Bergen, Norway
    2. Section of Mental Health Research, Division of Psychiatry, Helse Fonna HF, Norway
    3. Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
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  • Ann Kristin Knudsen,

    1. Mental Health Epidemiology, Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Bergen, Norway
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  • Arnstein Mykletun,

    1. Mental Health Epidemiology, Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Bergen, Norway
    2. Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway
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  • Sverre Nesvåg,

    1. Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
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  • Simon Øverland

    1. Mental Health Epidemiology, Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Bergen, Norway
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Jens Christoffer Skogen, Research Centre for Health Promotion, University of Bergen, Christiesgt 13, N-5015 Bergen, Norway. E-mail: jens.skogen@uib.no

ABSTRACT

Aims  To examine associations of abstention, alcohol consumption and problem drinking with subsequent disability pensioning (DP), and whether previous excessive consumption (‘sick-quitting’) could explain some of the increased risk for DP among abstainers.

Design  Prospective population-based study.

Setting and participants  Data were from two waves of the Nord-Trøndelag Health Study (HUNT) linked with the national insurance database. The two main analyses included 37 729 (alcohol consumption) and 34 666 (problem drinking) participants.

Measurements  Alcohol consumption was measured by self-reported consumption, while problem drinking was assessed by the Cut down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire. Information on subsequent DP, including diagnosis for which the DP was awarded, was gathered from the national insurance database. Covariates included somatic illness and symptoms, mental health, health-related behaviour, socio-economic status and social activity.

Findings  Those reporting the highest level of alcohol consumption were not at increased risk for DP [hazard ratio (HR) 1.12, 95% confidence interval (CI): 0.92–1.38], whereas problem drinking was a strong predictor (HR 2.79, 95% CI: 2.08–3.75) compared to their corresponding reference groups. Alcohol abstainers were also at increased risk for DP, but among them, the previous consumers (HR 1.95, 95% CI: 1.48–2.57) and previous excessive consumers (HR 1.67, 95% CI: 1.01–2.74) were at higher risk for DP than constant abstainers.

Conclusions  Problem drinking is linked to subsequent requirement for a disability pension but mere alcohol consumption is not. This is partly explained by ‘sick-quitting’.

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