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Alcohol-related deaths and social factors in depression mortality: a register-based follow-up of depressed in-patients and antidepressant users in Finland.
J Affect Disord. 2013 Jun; 148(2-3):278-85.JA

Abstract

BACKGROUND

Excess mortality of depression is established for various causes of death, but evidence is scarce on alcohol-related causes. It also remains unclear whether the magnitude of the excess varies by social factors. This study aimed to quantify the contribution of alcohol-related causes of death and to assess modifying effects of socioeconomic position, employment status, and living arrangements in the excess mortality of depression.

METHODS

A 14% sample of community-dwelling Finns aged 40-64 at the end of 1997 was assessed for depression, using register data on psychiatric hospital care and antidepressant use in 1996-1997. Depressed in-patients (n=897), out-patients using antidepressants (n=13,658), and non-depressed individuals (n=217,140) were followed up for cause-specific mortality in 1998-2007, distinguishing between alcohol- and non-alcohol-related deaths, and testing for variation in the excess mortality according to baseline social factors.

RESULTS

Depressed in- and out-patients had significant excess mortality for suicide (age-adjusted rate ratios RR=3.77 for men and RR=6.35 for women), all accidental and violent causes (RR=3.47 and RR=4.43), and diseases (RR=1.67 and RR=1.41). Of the excess, alcohol-related causes accounted for 50% among depressed men and 30% among women. Excess mortality varied little by social factors, particularly in non-alcohol-related causes. Where variation was significant, the relative excess was larger among those with higher socioeconomic position and the employed. Absolute excess was, however, larger among those with lower socioeconomic position, the unemployed, and the unpartnered.

LIMITATIONS

Depression was measured indirectly by hospital and antidepressant use.

CONCLUSIONS

The results highlight the major role of alcohol in depression mortality.

Authors+Show Affiliations

Population Research Unit, Department of Social Research, PO Box 18, 00014 University of Helsinki, Finland. heta.moustgaard@helsinki.fiNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23357655

Citation

Moustgaard, Heta, et al. "Alcohol-related Deaths and Social Factors in Depression Mortality: a Register-based Follow-up of Depressed In-patients and Antidepressant Users in Finland." Journal of Affective Disorders, vol. 148, no. 2-3, 2013, pp. 278-85.
Moustgaard H, Joutsenniemi K, Sihvo S, et al. Alcohol-related deaths and social factors in depression mortality: a register-based follow-up of depressed in-patients and antidepressant users in Finland. J Affect Disord. 2013;148(2-3):278-85.
Moustgaard, H., Joutsenniemi, K., Sihvo, S., & Martikainen, P. (2013). Alcohol-related deaths and social factors in depression mortality: a register-based follow-up of depressed in-patients and antidepressant users in Finland. Journal of Affective Disorders, 148(2-3), 278-85. https://doi.org/10.1016/j.jad.2012.12.008
Moustgaard H, et al. Alcohol-related Deaths and Social Factors in Depression Mortality: a Register-based Follow-up of Depressed In-patients and Antidepressant Users in Finland. J Affect Disord. 2013;148(2-3):278-85. PubMed PMID: 23357655.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alcohol-related deaths and social factors in depression mortality: a register-based follow-up of depressed in-patients and antidepressant users in Finland. AU - Moustgaard,Heta, AU - Joutsenniemi,Kaisla, AU - Sihvo,Sinikka, AU - Martikainen,Pekka, Y1 - 2013/01/26/ PY - 2012/07/02/received PY - 2012/12/03/revised PY - 2012/12/05/accepted PY - 2013/1/30/entrez PY - 2013/1/30/pubmed PY - 2014/8/15/medline SP - 278 EP - 85 JF - Journal of affective disorders JO - J Affect Disord VL - 148 IS - 2-3 N2 - BACKGROUND: Excess mortality of depression is established for various causes of death, but evidence is scarce on alcohol-related causes. It also remains unclear whether the magnitude of the excess varies by social factors. This study aimed to quantify the contribution of alcohol-related causes of death and to assess modifying effects of socioeconomic position, employment status, and living arrangements in the excess mortality of depression. METHODS: A 14% sample of community-dwelling Finns aged 40-64 at the end of 1997 was assessed for depression, using register data on psychiatric hospital care and antidepressant use in 1996-1997. Depressed in-patients (n=897), out-patients using antidepressants (n=13,658), and non-depressed individuals (n=217,140) were followed up for cause-specific mortality in 1998-2007, distinguishing between alcohol- and non-alcohol-related deaths, and testing for variation in the excess mortality according to baseline social factors. RESULTS: Depressed in- and out-patients had significant excess mortality for suicide (age-adjusted rate ratios RR=3.77 for men and RR=6.35 for women), all accidental and violent causes (RR=3.47 and RR=4.43), and diseases (RR=1.67 and RR=1.41). Of the excess, alcohol-related causes accounted for 50% among depressed men and 30% among women. Excess mortality varied little by social factors, particularly in non-alcohol-related causes. Where variation was significant, the relative excess was larger among those with higher socioeconomic position and the employed. Absolute excess was, however, larger among those with lower socioeconomic position, the unemployed, and the unpartnered. LIMITATIONS: Depression was measured indirectly by hospital and antidepressant use. CONCLUSIONS: The results highlight the major role of alcohol in depression mortality. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/23357655/Alcohol_related_deaths_and_social_factors_in_depression_mortality:_a_register_based_follow_up_of_depressed_in_patients_and_antidepressant_users_in_Finland_ DB - PRIME DP - Unbound Medicine ER -