Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 1;22(1):983.
doi: 10.1186/s12913-022-08389-1.

Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension

Helena Leppänen  1   2 , Olli Kampman  3   4 , Reija Autio  5 , Tino Karolaakso  6 , Turkka Näppilä  7 , Päivi Rissanen  5 , Sami Pirkola  4   5
Affiliations

Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension

Helena Leppänen et al. BMC Health Serv Res. .

Abstract

Background: Research in high-income countries has identified low socioeconomic status as a risk factor for disability pension (DP) due to common mental disorders (CMDs). Psychotherapy is an evidence-based treatment for the majority of CMDs along with medication and it is often targeted to prevent work disability. This study examines socioeconomic differences in the use of rehabilitative psychotherapy in Finland, where citizens have universal health coverage, but psychotherapy is partly dependent on personal finance.

Methods: The study subjects (N = 22,501) were all the Finnish citizens granted a DP due to CMD between 2010 and 2015 and a comparison group (N = 57,732) matched based on age, gender, and hospital district. Socioeconomic differences in psychotherapy use were studied using logistic regression models. Socioeconomic status was defined by education, income, and occupation. Age, gender, and family status were also examined.

Results: A lower level of education, lower occupational status (blue-collar worker), male gender, and older age, were associated with less frequent psychotherapy use, in both groups. Education was the strongest component of socioeconomic status associated with psychotherapy use, but the role of income was not straightforward. Unemployment when approaching DP, but not otherwise, was a risk factor for not receiving rehabilitative psychotherapy. Socioeconomic disparities were not any smaller among CMD patients approaching DP than in the comparison group.

Conclusion: This study demonstrates the disparity in the provision of psychotherapy for CMD patients, even on the verge of DP with an acute need for services. This disparity is partly related to a complex interplay of socioeconomic factors and the service system characteristics. Factors predisposing to unequal access to mental health services are presumably diverse and should be studied further.

Keywords: Anxiety; Common mental disorder; Depression; Disability pension; Psychotherapy; Socioeconomic status.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Distribution of psychotherapy years around DP year in CMD + DP group and comparison group
Fig. 2
Fig. 2
Socioeconomic and sociodemographic factors associated with psychotherapy use separately for CMD + DP group and comparison group
See this image and copyright information in PMC

References

    1. Viola S, Moncrieff J. Claims for sickness and disability benefits owing to mental disorders in the UK: trends from 1995 to 2014. BJPsych Open. 2016;2:18–24. doi: 10.1192/bjpo.bp.115.002246. - DOI - PMC - PubMed
    1. König H, König HH, Konnopka A. The excess costs of depression: a systematic review and meta-analysis. Epidemiol Psychiatr Sci. 2020;29(e30):1–16. doi: 10.1017/S2045796019000180. - DOI - PMC - PubMed
    1. World Health Organization. Depression and other common mental disorders: global health estimates 2017. https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017... (accessed November 6, 2021).
    1. Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, et al. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. Int J Epidemiol. 2014;43:476–493. doi: 10.1093/ije/dyu038. - DOI - PMC - PubMed
    1. Lahelma E, Pietiläinen O, Rahkonen O, Lallukka T. Common mental disorders and cause-specific disability retirement. Occup Environ Med. 2015;72:181–187. doi: 10.1136/oemed-2014-102432. - DOI - PubMed