J Affect Disord. 2021 Dec 22;299:528-535. doi: 10.1016/j.jad.2021.12.071. Epub 2021 Dec 22.
Antidepressant use among immigrants with depressive disorder living in Finland: A register-based study.
Journal of affective disorders
Valentina Kieseppä, Niina Markkula, Heidi Taipale, Minna Holm, Markus Jokela, Jaana Suvisaari, Antti Tanskanen, Mika Gissler, Venla Lehti
Affiliations
Affiliations
- Finnish Institute for Health and Welfare, Finland, Equality Unit, Helsinki. Electronic address: [email protected].
- University of Helsinki and Helsinki University Hospital, Finland, Department of Psychiatry, Helsinki; Clínica Alemana Universidad del Desarrollo, Chile, Faculty of Medicine, Santiago.
- Karolinska Institutet, Sweden, Department of Clinical Neuroscience, Stockholm; Niuvanniemi Hospital, Finland, Kuopio; University of Eastern Finland, Finland, School of Pharmacy, Kuopio.
- Finnish Institute for Health and Welfare, Finland, Equality Unit, Helsinki.
- University of Helsinki, Finland, Medicum, Department of Psychology and Logopedics, Helsinki.
- Niuvanniemi Hospital, Finland, Kuopio; University of Eastern Finland, Finland, School of Pharmacy, Kuopio.
- Finnish Institute for Health and Welfare, Finland, Information Services Department, Helsinki; University of Turku, Finland, Research Centre for Child Psychiatry, Turku; Region Stockholm, Sweden, Academic Primary Health Care Centre, Stockholm, and Karolinska Institute, Sweden, Department of Molecular Medicine and Surgery, Stockholm.
- Finnish Institute for Health and Welfare, Finland, Equality Unit, Helsinki; University of Helsinki and Helsinki University Hospital, Finland, Department of Psychiatry, Helsinki.
PMID: 34953922
DOI: 10.1016/j.jad.2021.12.071
Abstract
BACKGROUND: The aim of this study was to examine differences in the initiation and discontinuation of antidepressants between immigrants and the Finnish-born population diagnosed with depression in specialized health care.
METHODS: The study utilized register-based data, which includes all immigrants living in Finland at the end of 2010 and matched Finnish-born controls. For this study, we selected individuals who had received a diagnosis of depression during 2011-2014 (immigrants n = 2244, Finnish-born n = 2773). Their antidepressant use was studied for a one-year period from initiation. A logistic regression was used to predict initiation and a Cox regression was used to predict discontinuation.
RESULTS: Immigrants were more likely to initiate the use of antidepressants than the Finnish-born controls (adjusted OR = 1.25, 95% CI = 1.07-1.46), but they also discontinued the medication earlier than the Finnish-born controls (adjusted HR = 1.48, 95% CI = 1.31-1.68). Immigrants from Sub Saharan Africa, the Middle East and Northern Africa were most likely to discontinue antidepressants earlier. More severe depression, a longer length of residence in Finland and more intensive psychiatric treatment were associated with decreased risk of discontinuation.
LIMITATIONS: The registers do not provide information on the perceived reasons for the discontinuation.
CONCLUSIONS: Immigrants with depression initiate antidepressants more often than the Finnish-born population, but they also discontinue them earlier. Early discontinuation may be a sign of insufficient treatment suggesting that there could be a need for improvement in mental health care for immigrants in Finland.
Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.
Keywords: antidepressive agents; depression; transients and migrants
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