Socioeconomic status, antidepressant use, and return to work after disability due to common mental disorders

Abstract Background Common mental disorders (CMDs) are significant causes of work disability. Low socioeconomic status (SES) is a known risk factor for CMDs and work disability, one possible reason being poorer treatment adherence. We aimed to study the realization of pharmacological treatment and a...

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Main Authors: Helena Leppänen, Olli Kampman, Reija Autio, Antti Tanskanen, Heidi Taipale, Tino Karolaakso, Päivi Rissanen, Turkka Näppilä, Sami Pirkola
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:European Psychiatry
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Online Access:https://www.cambridge.org/core/product/identifier/S0924933825100461/type/journal_article
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author Helena Leppänen
Olli Kampman
Reija Autio
Antti Tanskanen
Heidi Taipale
Tino Karolaakso
Päivi Rissanen
Turkka Näppilä
Sami Pirkola
author_facet Helena Leppänen
Olli Kampman
Reija Autio
Antti Tanskanen
Heidi Taipale
Tino Karolaakso
Päivi Rissanen
Turkka Näppilä
Sami Pirkola
author_sort Helena Leppänen
collection DOAJ
description Abstract Background Common mental disorders (CMDs) are significant causes of work disability. Low socioeconomic status (SES) is a known risk factor for CMDs and work disability, one possible reason being poorer treatment adherence. We aimed to study the realization of pharmacological treatment and antidepressant adherence in patients with CMDs 3 years before and 3 years after being granted a disability pension (DP) and the role of SES in this. We also studied whether antidepressant adherence is associated with return to work (RTW) after a temporary DP. Methods Information on all persons granted a DP due to CMD between 2010 and 2012 in Finland (n = 12,388) was retrieved from national registers, which included medical, socioeconomic, and sociodemographic information of the subjects. We used the PRE2DUP method to estimate drug use periods and regression analyses to study associations between SES, taking medications, and RTW. Results Prevalence of taking antidepressants increased towards the DP grant and decreased thereafter, but 14.6% of subjects did not take antidepressants or antipsychotics at all during the study period. Of SES factors, only income was positively associated with antidepressant adherence, lasting over a year. Antidepressant adherence was not associated with RTW. Conclusions An alarming result was the absence of recommended medication in fewer than every seventh patient estimated to be disabled due to pharmacologically treatable psychiatric disorders. Contrary to expectations, SES had only a minor predictive role in antidepressant adherence in this patient group. Contrary to taking antidepressants, rehabilitation was associated with RTW. The results adduced the importance of CMD treatment optimization regardless of SES.
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spelling doaj-art-8a54985dc36e4b93bf9326a25b34c8f32025-08-20T02:21:29ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.10046Socioeconomic status, antidepressant use, and return to work after disability due to common mental disordersHelena Leppänen0https://orcid.org/0000-0002-1051-3200Olli Kampman1https://orcid.org/0000-0001-6891-2266Reija Autio2https://orcid.org/0000-0002-6519-2715Antti Tanskanen3https://orcid.org/0000-0002-3795-3126Heidi Taipale4https://orcid.org/0000-0002-3281-934XTino Karolaakso5https://orcid.org/0000-0002-7875-8079Päivi Rissanen6https://orcid.org/0000-0003-4779-6221Turkka Näppilä7https://orcid.org/0000-0002-0562-7254Sami Pirkola8https://orcid.org/0000-0003-0138-3130Faculty of Medicine and Health Technology, https://ror.org/033003e23 Tampere University , Tampere, Finland Department of Psychiatry, The Wellbeing Services County of Pirkanmaa, FinlandDepartment of Psychiatry, The Wellbeing Services County of Pirkanmaa, Finland Department of Clinical Sciences, Psychiatry, https://ror.org/05kb8h459 Umeå University , Umeå, Sweden Faculty of Medicine, Department of Clinical Medicine (Psychiatry), https://ror.org/05vghhr25 University of Turku , Finland Department of Psychiatry, The Wellbeing Services County of Ostrobothnia, FinlandFaculty of Social Sciences, Tampere University, Tampere, Finlandhttps://ror.org/033c4qc49 Niuvanniemi Hospital , Kuopio, Finland Department of Clinical Neuroscience, Karolinska Institutet, Center for Psychiatry Research, Stockholm, Swedenhttps://ror.org/033c4qc49 Niuvanniemi Hospital , Kuopio, Finland Department of Clinical Neuroscience, Karolinska Institutet, Center for Psychiatry Research, Stockholm, Sweden School of Pharmacy, https://ror.org/00cyydd11 University of Eastern Finland , Kuopio, FinlandFaculty of Social Sciences, Tampere University, Tampere, FinlandFaculty of Social Sciences, Tampere University, Tampere, FinlandTampere University Library, Tampere University, Tampere, FinlandDepartment of Psychiatry, The Wellbeing Services County of Pirkanmaa, Finland Faculty of Social Sciences, Tampere University, Tampere, FinlandAbstract Background Common mental disorders (CMDs) are significant causes of work disability. Low socioeconomic status (SES) is a known risk factor for CMDs and work disability, one possible reason being poorer treatment adherence. We aimed to study the realization of pharmacological treatment and antidepressant adherence in patients with CMDs 3 years before and 3 years after being granted a disability pension (DP) and the role of SES in this. We also studied whether antidepressant adherence is associated with return to work (RTW) after a temporary DP. Methods Information on all persons granted a DP due to CMD between 2010 and 2012 in Finland (n = 12,388) was retrieved from national registers, which included medical, socioeconomic, and sociodemographic information of the subjects. We used the PRE2DUP method to estimate drug use periods and regression analyses to study associations between SES, taking medications, and RTW. Results Prevalence of taking antidepressants increased towards the DP grant and decreased thereafter, but 14.6% of subjects did not take antidepressants or antipsychotics at all during the study period. Of SES factors, only income was positively associated with antidepressant adherence, lasting over a year. Antidepressant adherence was not associated with RTW. Conclusions An alarming result was the absence of recommended medication in fewer than every seventh patient estimated to be disabled due to pharmacologically treatable psychiatric disorders. Contrary to expectations, SES had only a minor predictive role in antidepressant adherence in this patient group. Contrary to taking antidepressants, rehabilitation was associated with RTW. The results adduced the importance of CMD treatment optimization regardless of SES. https://www.cambridge.org/core/product/identifier/S0924933825100461/type/journal_articleantidepressantscommon mental disordersdisability pensionreturn to worksocioeconomic status
spellingShingle Helena Leppänen
Olli Kampman
Reija Autio
Antti Tanskanen
Heidi Taipale
Tino Karolaakso
Päivi Rissanen
Turkka Näppilä
Sami Pirkola
Socioeconomic status, antidepressant use, and return to work after disability due to common mental disorders
European Psychiatry
antidepressants
common mental disorders
disability pension
return to work
socioeconomic status
title Socioeconomic status, antidepressant use, and return to work after disability due to common mental disorders
title_full Socioeconomic status, antidepressant use, and return to work after disability due to common mental disorders
title_fullStr Socioeconomic status, antidepressant use, and return to work after disability due to common mental disorders
title_full_unstemmed Socioeconomic status, antidepressant use, and return to work after disability due to common mental disorders
title_short Socioeconomic status, antidepressant use, and return to work after disability due to common mental disorders
title_sort socioeconomic status antidepressant use and return to work after disability due to common mental disorders
topic antidepressants
common mental disorders
disability pension
return to work
socioeconomic status
url https://www.cambridge.org/core/product/identifier/S0924933825100461/type/journal_article
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