High prevalence of early onset mental disorders among long-term disability claimants

Friday, November 1, 2013
First author:
Cornelius B.
Participation through Paid Work

1 Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, The Netherlands

2 Research Center for Insurance Medicine, The Netherlands

3 Social Security Institute, the Netherlands

4 Department of Health Sciences, VU University, Amsterdam, the Netherlands

All authors:

Bert Cornelius1,2,3, Jac J.L van der Klink1,2, Michiel R. de Boer1,2,4, Sandra Brouwer1,2, Johan W. Groothoff1

Inclusive Employment
DSM-IV - prevalence – comorbidity – age-of-onset – severity - mental disorder – disability


This study aims to provide information on prevalence, mental-mental and somatic-mental comorbidity, age-of-onset, and severity of mental disorders among persons claiming disability after long-term sickness absence. Such information is needed to promote return to work and to prevent unnecessary disability.


Cross-sectional analysis of a nationally representative sample of Dutch disability claimants (n=346). CIDI 3.0 was used to generate lifetime, 12-month and 30-day DSM-IV classifications of mental disorder, age-of-onset and severity; registry data on demographics and ICD-10 classifications of somatic disorder certified as primary cause of disability were obtained.


The mean age of respondents was 49.8 (range 22-64). The prevalence of DSM-IV classifications was 69.9% for lifetime, 44.5% for 12-month and 25.4% for 30-day mental disorder. The most prevalent broad categories of mental disorders were mood, anxiety and substance use disorder with a 12-month prevalence of 28.6%, 32.9% and 4.6%, respectively. Mood and most anxiety disorders had ages of onset in adolescence and early adulthood. The phobias start at school age. Of all respondents, 33.7% had ≥ 1 12-month mental disorder. Co-occurrence of substance use disorders, phobias and depression/anxiety disorders are frequent. Urogenital and gastrointestinal diseases, and cancer coincide with 12-month mental disorder in 66.7%, 53.9% and 51.7% of cases, respectively. More than two out of three specific mental disorders are serious in terms of impairment and disability.


Disability claimants constitute a vulnerable population with a high prevalence of serious mental disorder, substantial comorbidity and ages-of-onset in early working careers.