Antidepressant utilisation patterns and determinants of short-term and non-psychiatric use in the Finnish general adult population.
BACKGROUND
The aim was to study utilisation patterns and determinants of antidepressant use in the general population >30 years, especially short-term use or use not related to known psychiatric morbidity.


METHODS
Participants from a cross-sectional population-based Finnish Health 2000 Study (2000--2001) were linked with the National Prescription Register and National Care Register for Health Care. Within a representative sample (N=7112) of the adult population (>30 years), 12-month DSM-IV depressive, anxiety, and alcohol use disorders were assessed with the M-CIDI. Utilisation patterns of antidepressants were categorised to short-term, intermittent and continuous use. Factors predicting short-term use or use not related to known psychiatric morbidity were investigated.


RESULTS
Of Finnish adults 7.1% had used antidepressants in 2000, of which two-thirds reported a physician-diagnosed mental disorder; a third (35%) had major depressive or anxiety disorder during the previous 12 months. In terms of utilisation pattern, 43% were long-term users, 32% intermittent users and 26% short-term users. Short-term use was related to care by a general practitioner and having no known mental disorder. A quarter of all users had no known psychiatric morbidity. This type of user was most common among the older age groups, and inversely related to being single, on disability pension and using mental health services.


CONCLUSIONS
Not all psychiatric indications for antidepressant use could be explored.


CONCLUSIONS
Depression remains the main indication for antidepressant use. About a quarter of users had no known psychiatric indication and the indication remained unclear. Short-term and non-psychiatric use are more commonly prescribed for the elderly.
Sihvo
Sinikka
S
STAKES National Research and Development Centre for Welfare and Health, Helsinki, Finland. sinikka.sihvo@stakes.fi
Isometsä
Erkki
E
Kiviruusu
Olli
O
Hämäläinen
Juha
J
Suvisaari
Jaana
J
Perälä
Jonna
J
Pirkola
Sami
S
Saarni
Samuli
S
Lönnqvist
Jouko
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D019973:Alcohol-Related Disorders / Q000188:drug therapy / Q000453:epidemiology; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy / Q000453:epidemiology; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data; D012847:Single Person / Q000706:statistics & numerical data
D000928:Antidepressive Agents