Antidepressant use among immigrants with depressive disorder living in Finland: A register-based study.

Valentina Kieseppä, Niina Markkula, Heidi Taipale, Minna Holm, Markus Jokela, Jaana Suvisaari, Antti Tanskanen, Mika Gissler, Venla Lehti

Journal of affective disorders 2022 Feb 15

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The aim of this study was to examine differences in the initiation and discontinuation of antidepressants between immigrants and the Finnish-born population diagnosed with depression in specialized health care. The study utilized register-based data, which includes all immigrants living in Finland at the end of 2010 and matched Finnish-born controls. For this study, we selected individuals who had received a diagnosis of depression during 2011-2014 (immigrants n = 2244, Finnish-born n = 2773). Their antidepressant use was studied for a one-year period from initiation. A logistic regression was used to predict initiation and a Cox regression was used to predict discontinuation. Immigrants were more likely to initiate the use of antidepressants than the Finnish-born controls (adjusted OR = 1.25, 95% CI = 1.07-1.46), but they also discontinued the medication earlier than the Finnish-born controls (adjusted HR = 1.48, 95% CI = 1.31-1.68). Immigrants from Sub Saharan Africa, the Middle East and Northern Africa were most likely to discontinue antidepressants earlier. More severe depression, a longer length of residence in Finland and more intensive psychiatric treatment were associated with decreased risk of discontinuation. The registers do not provide information on the perceived reasons for the discontinuation. Immigrants with depression initiate antidepressants more often than the Finnish-born population, but they also discontinue them earlier. Early discontinuation may be a sign of insufficient treatment suggesting that there could be a need for improvement in mental health care for immigrants in Finland. Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

Citation

Valentina Kieseppä, Niina Markkula, Heidi Taipale, Minna Holm, Markus Jokela, Jaana Suvisaari, Antti Tanskanen, Mika Gissler, Venla Lehti. Antidepressant use among immigrants with depressive disorder living in Finland: A register-based study. Journal of affective disorders. 2022 Feb 15;299:528-535