Skip navigation
Skip navigation

Socioeconomic differences in antidepressant use in the PATH through life study: evidence of health inequalities, prescribing bias, or an effective social safety net?

Butterworth, Peter; Olesen, Sarah C.; Leach, L. S.

Description

BACKGROUND: Depression is more common amongst those who are economically disadvantaged. However there is inconsistent evidence concerning the relationship between socioeconomic position and antidepressant use. Moreover, evidence of greater antidepressant use amongst those of lower socioeconomic position may reflect their greater psychiatric morbidity, a prescribing bias towards pharmacological treatments, or provide evidence of an effective social safety net. This study investigates these...[Show more]

dc.contributor.authorButterworth, Peter
dc.contributor.authorOlesen, Sarah C.
dc.contributor.authorLeach, L. S.
dc.date.accessioned2015-03-04T01:49:11Z
dc.date.available2015-03-04T01:49:11Z
dc.identifier.issn0165-0327
dc.identifier.urihttp://hdl.handle.net/1885/12767
dc.description.abstractBACKGROUND: Depression is more common amongst those who are economically disadvantaged. However there is inconsistent evidence concerning the relationship between socioeconomic position and antidepressant use. Moreover, evidence of greater antidepressant use amongst those of lower socioeconomic position may reflect their greater psychiatric morbidity, a prescribing bias towards pharmacological treatments, or provide evidence of an effective social safety net. This study investigates these issues whilst addressing methodological limitations of earlier studies. METHOD: Data were from a large, random community survey of Australian adults (N=4493) with linked administrative data for primary-care service use. Depression was measured using the Patient Health Questionnaire, with other measures of current mental health and history of depression included in analysis. Multiple personal indicators and a combined measure of social disadvantage were considered. A series of analyses systematically examined competing explanations for socioeconomic differences in depression and antidepressant treatment. RESULTS: Markers of socioeconomic disadvantage were associated with a greater likelihood of antidepressant use. This finding was not attributable to the higher rates of depression amongst the disadvantaged. A similar pattern of results was evident for non-pharmaceutical treatments (primary care consultations). Socioeconomic position was not associated with use of complementary medications for depression, not covered by Australia's social safety net. LIMITATIONS:Analysis did not consider specialist mental health services. CONCLUSIONS: Socially disadvantaged respondents reported greater antidepressant use and service use after controlling for current depression symptoms. This pattern of findings suggests Australia's universal health-care system and social safety net may help address potential inequalities in health care.
dc.description.sponsorshipThis research was funded through grants from the National Health and Medical Research Council grant numbers nhmrc ID:525410 and nhmrc ID: 418039. PB, SO and LL are funded by an Australian National Health and Medical Research Council(NHMRC)Fellowships#525410,#1035690 and #1035803 respectively. The PATH through Life Survey is supported by NHMRC grants #973302, #179805and#157125.
dc.format9 pages
dc.publisherElsevier
dc.rights© 2013 Elsevier B.V.
dc.sourceJournal of Affective Disorders
dc.subjectAdult
dc.subjectAntidepressive Agents
dc.subjectAustralia
dc.subjectDepression
dc.subjectDepressive Disorder
dc.subjectFemale
dc.subjectHealth Status Disparities
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPhysician's Practice Patterns
dc.subjectSocial Support
dc.subjectSocioeconomic Factors
dc.subjectYoung Adult
dc.subjectAntidepressants
dc.subjectEpidemiology
dc.titleSocioeconomic differences in antidepressant use in the PATH through life study: evidence of health inequalities, prescribing bias, or an effective social safety net?
dc.typeJournal article
local.identifier.citationvolume149
dcterms.dateAccepted2013-01-14
dc.date.issued2013
local.identifier.absfor111714 - Mental Health
local.identifier.ariespublicationf5625xPUB3459
local.publisher.urlhttp://www.elsevier.com/
local.type.statusPublished version
local.contributor.affiliationButterworth, Peter John, Centre for Research on Ageing Health & Wellbeing, CMBE/RSPH, The Australian National University
dc.relationhttp://purl.org/au-research/grants/nhmrc/525410
dc.relationhttp://purl.org/au-research/grants/nhmrc/418039
dc.relationhttp://purl.org/au-research/grants/nhmrc/1035690
dc.relationhttp://purl.org/au-research/grants/nhmrc/1035803
dc.relationhttp://purl.org/au-research/grants/nhmrc/973302
dc.relationhttp://purl.org/au-research/grants/nhmrc/179805
dc.relationhttp://purl.org/au-research/grants/nhmrc/157125
local.identifier.essn1573-2517
local.bibliographicCitation.issue1-3
local.bibliographicCitation.startpage75
local.bibliographicCitation.lastpage83
local.identifier.doi10.1016/j.jad.2013.01.006
dc.date.updated2015-12-11T08:09:09Z
local.identifier.scopusID2-s2.0-84878475505
local.identifier.thomsonID000320593000009
CollectionsANU Research Publications

Download

There are no files associated with this item.


Items in Open Research are protected by copyright, with all rights reserved, unless otherwise indicated.

Updated:  19 May 2020/ Responsible Officer:  University Librarian/ Page Contact:  Library Systems & Web Coordinator