%0 Journal Article %T Adverse outcomes of sick leave due to mental disorders: A prospective study of discordant twin pairs %A Gunnar Bergstrˋm %A Lisa Mather %A Pia Svedberg %A Victoria Blom %J Scandinavian Journal of Public Health %@ 1651-1905 %D 2019 %R 10.1177/1403494817735755 %X Aims: The aim of this study was to investigate whether sick leave due to different mental disorders increased the risk of reoccurring sick-leave, disability pension and unemployment, taking genetics and shared environment into account. Methods: This register-based cohort study contains 2202 discordant twin pairs 18每64 years old, where one twin had sick leave due to a mental disorder 2005每2006. The end of the sick-leave spell was the start of follow-up for both twins. The twins were followed up for reoccurring sick-leave, disability pension and unemployment (> 180 days in a year), until December 2012. Analyses were censored for disability pension, death, emigration and old-age pension. Cox proportional hazards models with time-varying covariates were used to calculate hazard ratios with 95% confidence intervals (CI). Results: Those with sick leave due to mental disorders had a 3.64 (CI: 3.24每4.08) times higher risk of reoccurring sick-leave within the first two years; after that, hazard ratios were attenuated and explained by genetic factors. The first year, they had 12.24 (CI: 8.11每18.46) times the risk of disability pension. The risk was attenuated but remained at 2.75 (CI: 2.07每3.65) after one year. The risk of unemployment was 1.99 (CI: 1.72每2.31) during the whole follow-up period. The risk of unemployment and disability pension was lower for those with stress-related than other mental disorders, this was less clear for recurrent reoccuring sick-leave. Conclusions: Sick leave due to mental disorders increased the risk of reoccurring sick-leave within two years, disability pension and unemployment, independent of genetics and shared environment %K Sick Leave %K disability insurance %K unemployment %K twins %K mental disorders %U https://journals.sagepub.com/doi/full/10.1177/1403494817735755