title: Living alone and antidepressant medication use: a prospective study in a working-age population.
abstract: BACKGROUND
  An increasing proportion of the population lives in one-person households. The authors examined whether living alone predicts the use of antidepressant medication and whether socioeconomic, psychosocial, or behavioral factors explain this association.
  
  
  METHODS
  The participants were a nationally representative sample of working-age Finns from the Health 2000 Study, totaling 1695 men and 1776 women with a mean age of 44.6 years. In the baseline survey in 2000, living arrangements (living alone vs. not) and potential explanatory factors, including psychosocial factors (social support, work climate, hostility), sociodemographic factors (occupational grade, education, income, unemployment, urbanicity, rental living, housing conditions), and health behaviors (smoking, alcohol use, physical activity, obesity), were measured. Antidepressant medication use was followed up from 2000 to 2008 through linkage to national prescription registers.
  
  
  RESULTS
  Participants living alone had a 1.81-fold (CI = 1.46-2.23) higher purchase rate of antidepressants during the follow-up period than those who did not live alone. Adjustment for sociodemographic factors attenuated this association by 21% (adjusted OR = 1.64, CI = 1.32-2.05). The corresponding attenuation was 12% after adjustment for psychosocial factors (adjusted OR = 1.71, CI = 1.38-2.11) and 9% after adjustment for health behaviors (adjusted OR = 1.74, CI = 1.41-2.14). Gender-stratified analyses showed that in women the greatest attenuation was related to sociodemographic factors and in men to psychosocial factors.
  
  
  CONCLUSIONS
  These data suggest that people living alone may be at increased risk of developing mental health problems. The public health value is in recognizing that people who live alone are more likely to have material and psychosocial problems that may contribute to excess mental health problems in this population group.
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland. laura.pulkki-raback@helsinki.fi
authors.forename: Laura
authors.initials: L
authors.lastname: Pulkki-Råback
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: Kirsi
authors.initials: K
authors.lastname: Ahola
authors.forename: Kaisla
authors.initials: K
authors.lastname: Joutsenniemi
authors.forename: Marko
authors.initials: M
authors.lastname: Elovainio
authors.forename: Helena
authors.initials: H
authors.lastname: Rossi
authors.forename: Sampsa
authors.initials: S
authors.lastname: Puttonen
authors.forename: Seppo
authors.initials: S
authors.lastname: Koskinen
authors.forename: Erkki
authors.initials: E
authors.lastname: Isometsä
authors.forename: Jouko
authors.initials: J
authors.lastname: Lönnqvist
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D016000:Cluster Analysis; D004363:Drug Utilization; D004522:Educational Status; D004651:Employment / Q000523:psychology; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D011446:Prospective Studies; D011610:Psychosocial Deprivation; D012044:Regression Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents