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Past and present socioeconomic circumstances and psychotropic medication: a register-linkage study
  1. Elina Mauramo1,
  2. Tea Lallukka1,
  3. Mikko Laaksonen1,
  4. Pekka Martikainen2,
  5. Ossi Rahkonen1,
  6. Eero Lahelma1
  1. 1Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
  2. 2Department of Social Research, University of Helsinki, Helsinki, Finland
  1. Correspondence to Dr Tea Lallukka, Department of Public Health, Hjelt Institute, University of Helsinki, P.O. Box 41, FIN-00014 Helsinki, Finland; tea.lallukka{at}


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.

  • Socioeconomic
  • social inequalities
  • social epidemiology
  • health behaviour
  • occupational health
  • sickness absence
  • mortality
  • ageing
  • registers
  • marital status
  • medical sociology FQ

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  • Funding This study has been supported by Yrjö Jahnsson Foundation, the Finnish Work Environment Fund number 106065, and the Academy of Finland numbers 1121748, 1129225, 1135630, 133434 and 125733.

  • Competing interests None.

  • Ethics approval The Helsinki Health Study has been approved by ethical committees at the Department of Public Health, University of Helsinki, and at the City of Helsinki health authorities.

  • Provenance and peer review Not commissioned; externally peer reviewed.