Insomnia Symptoms, Sleep Duration, and Disability Pensions: a Prospective Study of Swedish Workers.

BACKGROUND: Previous studies have found insomnia and long sleep duration to be independently associated with subsequent disability pension (DP). However, the issue of a possible gender-based pattern in this context has received little attention. PURPOSE: This study aims to assess the impact of insomnia symptoms and sleep duration on the DP rates among Swedish women and men during a 12-year follow-up period. METHOD: The participants, from the general population of Malmö, Sweden, were enrolled from 1992 to 1994 (n = 4,319; participation rate 41 %), aged 45-64, healthy, and employed ≥30 h per week. Baseline inquiry data concerning psychosocial circumstances and self-reported sleep habits were compared with official register-based DP rates. RESULTS: Five hundred and nine persons were granted a DP. Insomnia symptoms, affirmed by 33 % of the men and 41 % of the women, were associated with receiving a DP; the hazard ratios in the fully adjusted model were 1.4 for both men [95 % confidence interval (CI) 1.1, 1.9] and women (95 % CI 1.1, 1.7). The fully adjusted hazard ratio for women sleeping ≥9 h was 7.8 (95 % CI 3.7, 16.6) for DP due to a mental disorder. In the age-adjusted analyses, the sub-domain "difficulties falling asleep" was related to DP due to mental disorders in men and DP due to cardiovascular diseases in women. CONCLUSION: The findings suggest that preventing and treating insomnia symptoms could reduce DP and that disease mechanisms linking sleep disturbances to DP may differ by gender

Can high psychological job demands, low decision latitude, and high job strain predict disability pensions? A 12-year follow-up of middle-aged Swedish workers.

OBJECTIVES: The aim of this study was to investigate whether job strain, psychological demands, and decision latitude are independent determinants of disability pension rates over a 12-year follow-up period. METHODS: We studied 3,181 men and 3,359 women, all middle-aged and working at least 30 h per week, recruited from the general population of Malmö, Sweden, in 1992. The participation rate was 41 %. Baseline data include sociodemographics, the Job Content Questionnaire, lifestyle, and health-related variables. Disability pension information was obtained through record linkage from the National Health Insurance Register. RESULTS: Nearly 20 % of the women and 15 % of the men were granted a disability pension during the follow-up period. The highest quartile of psychological job demands and the lowest quartile of decision latitude were associated with disability pensions when controlling for age, socioeconomic position, and health risk behaviours. In the final model, with adjustment also for health indicators and stress from outside the workplace, the hazard ratios for high strain jobs (i.e. high psychological demands in combination with low decision latitude) were 1.5 in men (95 % CI, 1.04-2.0) and 1.7 in women (95 % CI, 1.3-2.2). Stratifying for health at baseline showed that high strain tended to affect healthy but not unhealthy men, while this pattern was reversed in women. CONCLUSIONS: High psychological demands, low decision latitude, and job strain were all confirmed as independent risk factors for subsequent disability pensions. In order to increase chances of individuals remaining in the work force, interventions against these adverse psychosocial factors appear worthwhile

Synergistic interaction effect between job control and social support at work on general psychological distress

Purpose Little is known about the interaction between job control and social support at work on common mental disorders. To examine whether there is a synergistic interaction effect between job control and social support at work on general psychological distress and whether it differs by the level of job demands. Methods About 1,940 male and female workers from the Malmo Shoulder and Neck Study were chosen for this cross-sectional study. Job control, social support at work, and job demands were measured by the Swedish version of the Job Content Questionnaire, and general psychological distress was assessed by the General Health Questionnaire. Results A significant excessive risk increase for general psychological distress was observed when workers had both low job control and low social support at work in both men and women. The synergistic effect was stronger in women, when job demands were low (Rothman's synergy index was 2.16 vs. 1.51 when job demands were high). However, in male workers, while a strong synergistic effect between job control and social support at work was found when job demands were low (synergy index was 9.25), there was an antagonistic effect when job demands were high (synergy index was 0.52). Conclusions There was a synergistic interaction effect between job control and social support at work on general psychological distress, but the synergistic effect or its effect size differed by the level of job demands and gender. An atomic, additive approach to the risk assessment of the psychosocial work characteristics on common mental disorders could be misleading or lead to a risk underestimation

Spädbarnsskrik - en säkerhetsrisk?

A Dutch study is described, in which the occurrence of potentially detrimental parental actions induced by infant crying were assessed and thereafter related to various factors, including the parents’ judgment that the crying was »excessive«. A commentary in the same Lancet issue questions whether this might be interpreted as a »blaming of the victim« process. Official Swedish and international statistics on child abuse, especially a recent UNICEF report, are summarized. The co-occurrence of spouse and child abuse is briefly discussed. Southall and co-workers’ report on covert video recordings of life threatening child abuse is related, as well as some of the public reactions following it, and a proposed new categorization of child abuse

Infantile colic. Risk factors in pregnancy, maternal reports and outcome at 4 years of age

AIM: To study infantile colic in terms of occurrence, risk factors in pregnancy, distress patterns, caregiving practices, and outcome. STUDY DESIGNS: Paper I: Population study, 376 mothers and newborn infants, diaries or telephone interviews. Paper II: 116 colic and 119 control cases, telephone interviews, and diaries. Papers III-IV: Population study, 1099 mother-infant dyads, pregnancy inquiries, and telephone interviews. Paper V: 50 colic and 102 control cases from first study, postal inquiries. RESULTS: · The colic incidence, according to modified Wessel's criteria, was 11.7% in the first and 9.4% in the second study. · Diaries in the second study revealed generally low distress amounts: 1.1 hours/day in the control group, 1.6 hours/day in the non-Wessel colic group and 3.5 hours/day in the Wessel colic group. · In the Wessel colic group distress episodes were frequent and long-lasting and there was a high proportion of colicky crying vs. fussing/normal crying. · The average amounts of added holding and feeding time were, in the control, non-Wessel colic, and Wessel colic groups, 7.1, 7.9, and 9.1 hours/day, and the mean feeding frequencies were 10.0, 10.2, and 10.6 times/day. · Women who had stated in late pregnancy interviews that there is a risk of spoiling an infant with too much physical contact, were more likely to have infants with colic, and their infants were more distressed, even when actually given the same amount of physical contact. · There was a higher risk of colic in infants born to mothers with low instrumental support in pregnancy, and mothers with non-manual occupations. Having an 'active' job situation, i.e. high demands and high decision latitude at work, acted synergistically with a non-manual occupation, yielding even higher odds ratios for colic. · High trait anxiety in early pregnancy was a risk factor for colic, especially if combined with low maternal age. A high educational level reduced the effects of high trait anxiety. · In the 4-year follow-up study, there were no major differences between formerly colicky children and controls. However, in the ex-colicky group there were more negative emotions according to the temperament scale. Implications of the findings, as regards attentions in maternity health care to pregnant women in different risk groups, and on appropriate advice to give to parents in child health care, are discussed, and ideas for future research are outlined

Colicky infants according to maternal reports in telephone interviews and diaries: a large Scandinavian study.

In this population-based study the colic incidence was 9.4%, according to telephone interviews with the parents made when the infants were 5 weeks of age (n = 1628), and parental concern about infant crying was common. However, 7-day diaries of colicky and control infants (n = 116 + 119) revealed low distress amounts in colicky infants in general. In the subgroup of Wessel-colicky infants (n = 37), distress episodes were frequent and long lasting, and there was a high proportion of colicky crying versus fussing and normal crying. Even if there may be a reduction in the infantile colic incidence and support for the hypothesis that infantile colic is at least partially "in the eye of the beholder," that is, the concerned parent, a subgroup of infants may be more "genuinely colicky." Women who had stated in late-pregnancy interviews that there is a risk of spoiling an infant with too much physical contact were more likely to have infants with colic, and their infants were more distressed, even when given the same amount of physical contact. This finding warrants further elucidation

One-year incidence of sexual harassment and the contribution to poor mental health in the adult general population

Background: Sexual harassment (SH) has been highlighted as an important determinant for mental health. The aims of this study were to describe SH in terms of cumulative 1-year incidence, exposed groups, types of perpetrators and settings, and to measure the association between SH and poor mental well-being. Methods: Data from two waves of the Scania Public Health Cohort Study, comprising 7759 randomly recruited individuals above 18 years. Exposure to SH was measured by an instrument that also recorded place of exposure and type of perpetrator. Poor mental well-being was assessed by General Health Questionnaire (GHQ)-12, 36-Item Short Form Health Survey questionnaire (SF-36) (mental health module) and self-reported use of prescribed psychotropic medication. Logistic regression was used for multivariate analyses. Results: The cumulative 1-year incidence of SH was six times greater among women, the highest figure (17.5%) was noted for women 18-34 years of age. No difference was noted regarding educational level or country of origin. Public places, including public transportation, and unknown offenders were the most frequently reported setting of SH for both genders. Exposure to SH was associated with a doubled risk for low mental well-being, according to all three outcome definitions, and after adjustment for mental health 6 years earlier. Female gender was related to greater vulnerability to SH exposure concerning GHQ-12 and SF-36. The Population Attributable Fraction for poor mental health was calculated to 13% for women 34 years and younger. Conclusion: The results of this study make SH an important issue for gender policy as well as for public health policy and intervention