title: Past and present socioeconomic circumstances and psychotropic medication: a register-linkage study.
abstract: BACKGROUND
  Various domains of socioeconomic circumstances are associated with self-reported mental health, but we lack evidence from studies using medically confirmed mental health outcomes. This longitudinal study aimed to examine the associations of multiple domains of socioeconomic circumstances with subsequent prescribed psychotropic medication among Finnish public sector employees.
  
  
  METHODS
  Baseline survey data among 40-60-year-old employees of City of Helsinki were linked with Social Insurance Institution of Finland register data on psychotropic medication purchases (n=5563). HRs were calculated using Cox regression to examine associations of parental and own education, childhood and current economic difficulties, occupational class, household income and housing tenure with antidepressants, sleeping pills and sedatives and any psychotropic medication during a 5-year follow-up.
  
  
  RESULTS
  In age and previous psychotropic medication adjusted models, the risk of antidepressant medication was higher in those with childhood (women: HR=1.29, men: HR=1.64) and current economic difficulties (women: HR=1.30-1.54), rented housing (women: HR=1.20, men: HR=1.45) and the second lowest income group (men: HR=1.71). Gradual adjustments had little effect on the associations. For sleeping pills and sedatives, similar associations were found in women for current economic difficulties, and in men for housing tenure. Results for any psychotropic medication reflected those observed for antidepressants.
  
  
  CONCLUSIONS
  Past and present economic difficulties and housing tenure were more important determinants of subsequent psychotropic medication among employees than the conventional socioeconomic determinants. The associations were somewhat inconsistent between the medication groups and the sexes. The results support the importance of examining multiple domains of socioeconomic circumstances simultaneously.
authors.affiliation: Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.
authors.forename: Elina
authors.initials: E
authors.lastname: Mauramo
authors.forename: Tea
authors.initials: T
authors.lastname: Lallukka
authors.forename: Mikko
authors.initials: M
authors.lastname: Laaksonen
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
authors.forename: Ossi
authors.initials: O
authors.lastname: Rahkonen
authors.forename: Eero
authors.initials: E
authors.lastname: Lahelma
mesh_terms: D000328:Adult; D004651:Employment; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006306:Health Surveys; D006798:Housing; D006801:Humans; D015994:Incidence; D007182:Income; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D011203:Poverty; D015995:Prevalence; D016016:Proportional Hazards Models; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D017150:Public Sector; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D011619:Psychotropic Drugs