A Population-Based Study on Health Anxiety and Disability Pension Award

Studies exploring functional impairments in health anxiety are almost exclusively cross-sectional, and mainly carried out in clinical settings. As most cases never find their way into psychiatric treatment, our knowledge on the long-term prognosis of health anxiety as it occurs in the general population is limited. We aimed to study the long term prognosis of health anxiety by employing subsequent disability pension award as a measure of global functioning. Methods: Using a historical cohort design, we utilized a unique link between a large epidemiological cohort study and a comprehensive national database. Information on disability benefit recipiency was obtained from Norwegian registry data, and merged with health information, including health anxiety and a range of potential confounders, from the Hordaland Health Study (HUSK) in Western Norway, 1997-99. Participants (N = 6819) were aged 40-46 at baseline, and the mean time of follow-up after participation was 3.6 years. Results: Health anxiety was a strong independent risk factor for subsequent disability pension award. This effect was only partly accounted for by adjusting for gender, socio-demographic variables, somatic conditions, anxiety, depression and somatic symptoms. The increased risk of health anxiety on disability pension award was not only observed at the highest symptom levels. There was also a significant dose-response association. Conclusions: Health anxiety is associated with subsequent long-term work-related disability. The true effect of health anxiety on disability pension award appears to be underestimated in official registries