Background: Recent studies based on self-reported data suggest that retirement may have beneficial effects on mental health, but studies using objective endpoints remain scarce. This study examines longitudinally the changes in antidepressant medication use across the 9 years spanning the transition to retirement.
Methods: Participants were Finnish public-sector employees: 7138 retired at statutory retirement age (76% women; mean age, 61.2 years), 1238 retired early due to mental health issues (78% women; mean age, 52.0 years), and 2643 retired due to physical health issues (72% women; mean age, 55.4 years). Information on purchase of antidepressant medication 4 years before and 4 years after retirement year was based on comprehensive national pharmacy records in 1994–2005.
Results: One year before retirement, the use of antidepressants was 4% among those who would retire at statutory age, 61% among those who would retire due to mental health issues, and 14% among those who would retire due to physical health issues. Retirement-related changes in antidepressant use depended on the reason for retirement. Among old-age retirees, antidepressant medication use decreased during the transition period (age- and calendar-year-adjusted prevalence ratio for antidepressant use 1 year after versus 1 year before retirement = 0.77 [95% confidence interval = 0.68 to 0.88]). Among those whose main reason for disability pension was mental health issues or physical health issues, there was an increasing trend in antidepressant use prior to retirement and, for mental health retirements, a decrease after retirement.
Conclusions: Trajectories of recorded purchases of antidepressant medication are consistent with the hypothesis that retirement is beneficial for mental health.
From the aFinnish Institute of Occupational Health, Helsinki, Finland; bDepartment of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA; cDepartment of Public Health, University of Turku and Turku University Hospital, Turku, Finland; dStress Research Institute, Stockholm University, Stockholm, Sweden; eDepartment of Behavioral Sciences, University of Helsinki, Helsinki, Finland; and fDepartment of Epidemiology and Public Health, University College London Medical School, London, United Kingdom.
Submitted 8 September 2010; accepted 20 January 2011; posted 18 April 2011.
Supported by the National Institute on Aging, NIH, US (R01AG034454), the BUPA Foundation, UK, EU New OSH ERA research program, the participating organizations, and the Academy of Finland (grants 124271, 124322, 126602, 129262, and 132944).
Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article (www.epidem.com).
Editors' note: A commentary on this article appears on page 560.
Correspondence: Tuula Oksanen, Finnish Institute of Occupational Health, Lemminkäisenkatu 14-18 B, FIN-20520 Turku, Finland. E-mail: email@example.com.