Use of health services for major depressive episode in Finland.
BACKGROUND
A universal finding in psychiatric epidemiology is that only a minority of currently depressed people seek or receive treatment.


OBJECTIVE
To investigate the predictors of use of health care services for depression.


METHODS
A representative random sample of 5993 non-institutionalised Finnish individuals aged 15-75 years was interviewed in 1996. Major depressive episode during the last 12 months was assessed using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form). Characteristics and health service use of the 557 depressed individuals were assessed.


RESULTS
The proportion of people classified as having a major depressive episode who used any health services for their depression during the past 12 months was only 31% for men and 25% for women. Use of services was not predicted by sociodemographic factors. Longer duration, and greater severity and perceived disability predicted overall health service use for depression, but not significantly whether treatment was sought from primary or psychiatric care.


CONCLUSIONS
The probability of use of health services for major depression increases with duration, severity and perceived disability related to depression. Only 59% of those suffering from even the most severe major depressive episodes use health services for depression. Use appears to be unrelated to sociodemographic factors in Finland.
Hämäläinen
Juha
J
National Public Health Institute, Department of Mental Health and Alcohol Research, Helsinki, Finland. juha.hamalainen@ktl.fi
Isometsä
Erkki
E
Laukkala
Tanja
T
Kaprio
Jaakko
J
Poikolainen
Kari
K
Heikkinen
Martti
M
Lindeman
Sari
S
Aro
Hillevi
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D003710:Demography; D003866:Depressive Disorder / Q000628:therapy*; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D005387:Finland; D005544:Forecasting; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012720:Severity of Illness Index; D012923:Social Class