Major depressive episode and health care use among adolescents and young adults.
OBJECTIVE
The aim was to analyze how major depressive episode (MDE), chronic illness and their co-existence are associated with health care use in young people.


METHODS
As part of the Finnish Health Care Survey 1996, a random sample of 942 15 to 24-year-olds was interviewed. DS M-III-R MDE over the previous 12 months was assessed using the University of Michigan Composite Diagnostic Interview Short Form (UM-CIDI SF).


RESULTS
Of the study population, 43.7% (n=439) reported recent use of services for physical illness, the highest proportion being among respondents with both MDE and chronic illness (73.9 %). In multivariable logistic regression analysis, disabling chronic illness (OR 2.59; 95% CI 1.51, 4.45) was related to treatment use for physical causes while MDE alone (OR 1.56; 95% CI 0.95, 2.58) or accompanied with chronic illness (OR 2.47; 95% CI 0.99, 6.14) showed borderline associations. In all, 1.5% (n=14) of the respondents reported recent health care use for any mental health problems. Of the 68 subjects with MDE, 51.5% (n=35) were estimated to be in need of treatment while 20.6% (n=14) had actually sought care for depression during the preceding year. Psychosocial impairment showed borderline association with treatment use (OR 3.77; 95% CI 0.97, 14.7). Only two subjects (14 %) reported recent use of antidepressant medication.


CONCLUSIONS
MDE in adolescents and young adults is undertreated. Antidepressant medication was seldom used in Finland in 1996. Young people suffering from both MDE and chronic illness are likely to use services other than psychiatric services, and systematic screening for depressive symptoms in these treatment settings is recommended.
Haarasilta
Linnea
L
Dept. of Mental Health and Alcohol Research, National Public Health Institute, Mannerheimintie 160, 00300 Helsinki, Finland. linnea.haarasilta@ktl.fi
Marttunen
Mauri
M
Kaprio
Jaakko
J
Aro
Hillevi
H
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000628:therapy*; D017050:Episode of Care; D005260:Female; D005387:Finland / Q000453:epidemiology; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*
D000928:Antidepressive Agents