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

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 wo...

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Autores principales: Leppänen, Helena, Kampman, Olli, Autio, Reija, Karolaakso, Tino, Näppilä, Turkka, Rissanen, Päivi, Pirkola, Sami
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344663/
https://www.ncbi.nlm.nih.gov/pubmed/35915437
http://dx.doi.org/10.1186/s12913-022-08389-1
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author Leppänen, Helena
Kampman, Olli
Autio, Reija
Karolaakso, Tino
Näppilä, Turkka
Rissanen, Päivi
Pirkola, Sami
author_facet Leppänen, Helena
Kampman, Olli
Autio, Reija
Karolaakso, Tino
Näppilä, Turkka
Rissanen, Päivi
Pirkola, Sami
author_sort Leppänen, Helena
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08389-1.
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spelling pubmed-93446632022-08-03 Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension Leppänen, Helena Kampman, Olli Autio, Reija Karolaakso, Tino Näppilä, Turkka Rissanen, Päivi Pirkola, Sami BMC Health Serv Res Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08389-1. BioMed Central 2022-08-01 /pmc/articles/PMC9344663/ /pubmed/35915437 http://dx.doi.org/10.1186/s12913-022-08389-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Leppänen, Helena
Kampman, Olli
Autio, Reija
Karolaakso, Tino
Näppilä, Turkka
Rissanen, Päivi
Pirkola, Sami
Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension
title Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension
title_full Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension
title_fullStr Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension
title_full_unstemmed Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension
title_short Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension
title_sort socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344663/
https://www.ncbi.nlm.nih.gov/pubmed/35915437
http://dx.doi.org/10.1186/s12913-022-08389-1
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