{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:40:16Z","timestamp":1777938016923,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To examine trends in the treatment and rehabilitation of depression prior to disability pension application due to depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective register-based study included 30,105 applicants for disability pension due to depression, and it is based on data from the Social Insurance Institution of Finland (Kela). The trends in antidepressant purchases and rehabilitation measures during the year preceding the application were analysed for 2010\u20132019 using linear regression analysis, with analysis of covariance to assess the interactions of age- and sex-based population groups with these trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A stable proportion of approximately 1 in 10 (9.2%\u201312.2%) applicants had had neither antidepressant purchases nor psychotherapy in the preceding year, with no statistically significant trend (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.05). The proportion of applicants with a history of antidepressant use decreased slightly from 90.3% to 87.5%. However, the proportion of applicants with a history of psychotherapy or both psychotherapy and antidepressants doubled over the same period (from 6.1% to 13.5% and from 5.6% to 11.7%, respectively). Annually, estimated average antidepressant use declined by 0.25 percentage points, psychotherapy increased by 0.90 percentage points, and combined treatment increased by 0.75 percentage points, all statistically significant. A statistically significant interaction in psychotherapy trends was observed in population groups based on sex and age. The highest proportion of applicants receiving psychotherapy was among females under the age of 40.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      <jats:bold>The proportion of applicants for disability pension due to depression receiving psychotherapy has increased over time. However, most applicants, particularly older males, continue to receive only antidepressants and no rehabilitation.<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14034948261422954","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T06:15:38Z","timestamp":1772432138000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in depression treatment of persons applying for disability pension due to depression: a register-based retrospective study from Finland"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8923-2219","authenticated-orcid":false,"given":"Tero","family":"Kujanp\u00e4\u00e4","sequence":"first","affiliation":[{"name":"Social Insurance Institution of Finland (Kela), Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0286-3390","authenticated-orcid":false,"given":"Sauli","family":"J\u00e4ppinen","sequence":"additional","affiliation":[{"name":"Social Insurance Institution of Finland (Kela), Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsi","family":"Suominen","sequence":"additional","affiliation":[{"name":"Social Insurance Institution of Finland (Kela), Helsinki, Finland"},{"name":"Ilmarinen Mutual Pension Insurance Company, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veera","family":"Pohjolainen","sequence":"additional","affiliation":[{"name":"Ilmarinen Mutual Pension Insurance Company, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riitta","family":"Luoto","sequence":"additional","affiliation":[{"name":"Social Insurance Institution of Finland (Kela), Helsinki, Finland"},{"name":"University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,1]]},"reference":[{"key":"e_1_3_2_2_2","article-title":"Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"9","author":"Ferrari A","year":"2022","unstructured":"Ferrari A, Santomauro D, Mantilla A, et al. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry 2022;9:137\u201350.","journal-title":"Lancet Psychiatry"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-021-01703-0"},{"key":"e_1_3_2_4_2","article-title":"Depression and risk of disability pension: a systematic review and meta-analysis","volume":"2019","author":"Amiri S","unstructured":"Amiri S, Behnezhad S. Depression and risk of disability pension: a systematic review and meta-analysis. Int J Psychiatry Med 2019:91217419837412.","journal-title":"Int J Psychiatry Med"},{"key":"e_1_3_2_5_2","article-title":"The excess costs of depression: a systematic review and meta-analysis","volume":"29","author":"K\u00f6nig H","year":"2019","unstructured":"K\u00f6nig H, K\u00f6nig H-H, Konnopka A. The excess costs of depression: a systematic review and meta-analysis. Epidemiol Psychiatr Sci 2019;29:e30.","journal-title":"Epidemiol Psychiatr Sci"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-021-01019-4"},{"key":"e_1_3_2_7_2","first-page":"87","article-title":"Cost of depression in Europe","volume":"9","author":"Sobocki P","year":"2006","unstructured":"Sobocki P, J\u00f6nsson B, Angst J, et al. Cost of depression in Europe. J Ment Health Policy Econ 2006;9:87\u201398.","journal-title":"J Ment Health Policy Econ"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.07.004"},{"key":"e_1_3_2_9_2","unstructured":"Working group appointed by the Finnish Medical Society Duodecim and the Finnish Psychiatric Association. Depression. Current care guidelines. Helsinki: Finnish Medical Society Duodecim www.kaypahoito.fi (2025 accessed 13 March 2025)."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.116.188078"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.157.11.1869"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v68n1208"},{"key":"e_1_3_2_13_2","article-title":"Johtaako masennuksen huono hoito el\u00e4kkeelle?","volume":"68","author":"Suominen K","year":"2013","unstructured":"Suominen K, Kronqvist K, Karjalainen K, et al. Johtaako masennuksen huono hoito el\u00e4kkeelle? [Does poor treatment of depression lead to retirement?] Suom L\u00e4\u00e4k\u00e4rilehti 2013;68:232\u20136.","journal-title":"Suom L\u00e4\u00e4k\u00e4rilehti"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/08039488.2023.2232361"},{"key":"e_1_3_2_15_2","unstructured":"Liukko J. Decision-making practices in vocational rehabilitation under the earnings\u2011related pension system and the functioning and effectiveness of rehabilitation: a review based on expert interviews and literature. Report by Finnish Centre for Pensions Helsinki 2020."},{"key":"e_1_3_2_16_2","unstructured":"Kelasto Statistical Database. Data retrieved from the Kelasto statistical database maintained by The Social Insurance Institution of Finland https:\/\/tietotarjotin.fi\/tilastodata\/2051231\/tilastotietokanta-kelasto (accessed 26 March 2025)."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100368"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2022.05.014"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.151"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.146"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06712-w"}],"container-title":["Scandinavian Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14034948261422954","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14034948261422954","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14034948261422954","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:20:30Z","timestamp":1777695630000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14034948261422954"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,1]]},"references-count":20,"alternative-id":["10.1177\/14034948261422954"],"URL":"https:\/\/doi.org\/10.1177\/14034948261422954","relation":{},"ISSN":["1403-4948","1651-1905"],"issn-type":[{"value":"1403-4948","type":"print"},{"value":"1651-1905","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,1]]},"article-number":"14034948261422954"}}