Trends in depression treatment of persons applying for disability pension due to depression: a register-based retrospective study from Finland

To examine trends in the treatment and rehabilitation of depression prior to disability pension application due to depression.

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 2010-2019 using linear regression analysis, with analysis of covariance to assess the interactions of age- and sex-based population groups with these trends.

A stable proportion of approximately 1 in 10 (9.2%-12.2%) applicants had had neither antidepressant purchases nor psychotherapy in the preceding year, with no statistically significant trend (p < 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.

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.