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Insurance medicine and mental disorders

Mental disorders, such as depressive and anxiety disorders, can lead to long-term sick leave – but excessively prolonged sick leave can also aggravate the illness. Ellenor Mittendorfer-Rutz conducts research on the links between mental disorders and social insurance.

Ellenor Mittendorfer-Rutz, portrait.
Professor Ellenor Mittendorfer-Rutz, credit: Stefan Zimmerman.

What is your main area of research?

“My research is mainly situated at the intersection of psychiatric epidemiology and insurance medicine – that is to say, the study of mental disorders from a social insurance perspective. Above all, I am interested in long-term sick leave for mental disorders – what factors lead to it, what are its consequences, and what treatment is most effective in facilitating return to work. We have also started to specifically study mental disorders, suicidal behaviour and sickness absence among refugees and other migrants because they constitute a large group of people whose needs are often neglected.”
 

What are your most important discoveries?


“One clinically important finding relates to comorbidity. We have demonstrated that mental disorders severely impair the prognosis when it comes to work disability (i.e. sickness absence and disability pension) for people with cardiovascular disease, among other disorders. We have further developed a model that identifies patients who are at high risk of remaining on long-term sick leave based on clinical, psychosocial and socio-economic factors. With regard to refugees, we have demonstrated a surprising association: despite a higher prevalence of mental disorders in this group, the risk of suicide is lower than that of the rest of the Swedish population. Unfortunately, this is not the case for unaccompanied minors seeking asylum, among whom the suicide rate in 2017 was eight times higher than among their peers in Sweden. We reported this finding in a 2018 study that drew considerable attention.”
 

Is the subject of insurance medicine a timely one?


“Absolutely. After many years of neglect, this field is now evolving quickly. One reason behind this development is that common mental disorders like depression and anxiety are now the predominant causes of long-term sick leave and disability pension, so it is critical that we increase knowledge in the field. The goal is to reduce the costs, which are enormous – both in terms of human suffering and socio-economic aspects.”

Text: Anders Nilsson, in translation from Swedish
First published in From Cell to Society 2019

Ellenor Mittendorfer-Rutz

Professor of Insurance Medicine at the Department of Clinical Neuroscience

Ellenor Mittendorfer-Rutz was born
in 1970 in Linz, Austria. In 1997 she earned a Master of Nutrition Science degree at the University of Vienna.
She subsequently worked as an expert at the World Health Organization in Copenhagen from 1998 to 1999 and at the Food and Agriculture Organisation in Rome from 1999 to 2000.

From 1999 to 2001 she also worked as a research assistant at the Swedish Institute of Psychosocial Medicine (IPM) in Stockholm, and in 2005 she received her PhD at KI with a doctoral thesis on suicide risk factors. Following a period as a project coordinator at IPM, she returned to KI in 2008 and became an associate professor in 2013.

Ellenor Mittendorfer-Rutz was appointed Professor of Insurance Medicine at Karolinska Institutet on 1 April 2019.