Treatment seeking, treatment adequacy and outcome of depressive and anxiety disorders among young adults in Finland

Teija Kasteenpohja

Research output: ThesisDoctoral ThesisCollection of Articles

Abstract

According to epidemiological studies, depressive and anxiety disorders are common, often chronic or recurrent, but under-recognized and undertreated. The incidence of these disorders peaks in late adolescence and early adulthood, when they may be particularly harmful, since they often limit social, occupational and academic functioning. Therefore, recognition and adequate treatment of these disorders at this age period are especially important. The aims of this study were to describe adequate treatment and outcome of depressive and anxiety disorders in a Finnish general population sample of young adults. Data were derived from the Mental Health in Early Adulthood in Finland (MEAF) study which is a follow-up study of Health 2000 young adult sample, a nationally representative two-stage cluster sample of 1894 Finns aged 18 to 29 years. The follow-up of the MEAF study was carried out as a part of the Health 2011 study. The baseline assessment was conducted in 2003–2005, and the follow-up in 2011. This study showed that 76% of young adults with lifetime depressive disorders had had contact with the healthcare system, and 41% of them had received minimally adequate treatment. Women, and those with a substance use disorder, had visited a physician at least once more often than others, while having major depressive disorder was related to visits with a physician at least four times a year. Women had also had psychotherapy more often than men. A history of suicidality and lower education were related to dropping out from treatment. Treatment was adequate for 42% of those with a lifetime history of anxiety disorder (excluding those with only a specific phobia), and 71% of them had sought treatment. Comorbid personality disorder was related to benzodiazepine use, and comorbid substance use with antidepressant or buspirone medication lasting for at least two months. Those who were currently married or cohabiting were less likely than others to have visited a physician at least four times a year. In the follow-up study, 23% of those with a lifetime depressive and/or anxiety disorder at baseline had these disorders in 2011, whereas the corresponding figure was 10% for those with no DSM-IV diagnosis at baseline. Those with a history of depressive and/or anxiety disorder had poorer self-estimated quality of life and lower level of education compared to the control group in the follow-up. Sociodemographic factors, treatment, or cognitive factors at baseline did not predict persistence/recurrence of depressive and anxiety disorders or quality of life among those affected, but hypomanic features at baseline were associated with worse self-estimated quality of life in the follow-up. These results show that young people sought treatment more often than in previous studies, but the lack of adequate treatment was an ongoing problem. The prognosis of depressive and anxiety disorders is relatively favorable, since three-quarters of young adults with a lifetime history of these disorders recovered after 6-8 years of follow-up. However, these disorders had an impact on the level of education of affected people in the long term. In the future, barriers to adequate treatment in the healthcare system should be investigated and interventions to remove them should be launched. It is also important that educational policy supports the continuity of education for young people with mental disorders during, and also after, acute episodes.
Original languageEnglish
Supervisors/Advisors
  • Suvisaari, Jaana, Supervisor
  • Marttunen, Mauri, Supervisor
Award date14 Dec 2018
Place of PublicationHelsinki
Publisher
Print ISBNs978-951-51-4654-0
Electronic ISBNs978-951-51-4655-7
Publication statusPublished - 2018
MoE publication typeG5 Doctoral dissertation (article)

Bibliographical note

M1 - 132 s. + liitteet

Fields of Science

  • Depressive Disorder
  • +diagnosis
  • +therapy
  • Antidepressive Agents
  • Continuity of Patient Care
  • Depressive Disorder, Major
  • Help-Seeking Behavior
  • Neuropsychological Tests
  • Office Visits
  • 3124 Neurology and psychiatry

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