Socioeconomic status, antidepressant use, and return to work after disability due to common mental disorders
: Leppänen, Helena; Kampman, Olli; Autio, Reija; Tanskanen, Antti; Taipale, Heidi; Karolaakso, Tino; Rissanen, Päivi; Näppilä, Turkka; Pirkola, Sami
Publisher: Cambridge University Press
: 2025
: European Psychiatry
: European Psychiatry
: e79
: 68
: 1
: 0924-9338
: 1778-3585
DOI: https://doi.org/10.1192/j.eurpsy.2025.10046
: https://doi.org/10.1192/j.eurpsy.2025.10046
: https://research.utu.fi/converis/portal/detail/Publication/499474631
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.
MethodsInformation 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.
ResultsPrevalence 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.
ConclusionsAn 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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This work was supported by Wellbeing Services County research funds of Pirkanmaa and Ostrobothnia, the Finnish Psychiatric Association, and the Emil Aaltonen Foundation. The funding sources were not involved in the study design, in the collection, analysis, or interpretation of data, or in the writing of the article.