Antipsychotic medication use among working-age first-generation migrants resident in Finland: An administrative data linkage study.

Aims: Higher incidence of psychotic disorders in high-income countries for migrants compared with the settled majority has been well established. However, it is less clear to what extent different migrants groups have accessed and utilised mental health care. This study aimed to identify the hazard of antipsychotic medication use in the largest migrant groups in Finland, compared with a Finnish-born comparison group, using high quality datasets maintained by Statistics Finland and Social Insurance Institution Finland, and linking socio-demographic and -economic characteristics to antipsychotic prescription purchases. Methods: The study draws on a representative sample of 33% of the adult working-age population of Finland in 2005 (n = 1,059,426, 50.2% male, 2.5% migrant). The use of antipsychotic drugs was followed-up from 2005 to 2014. Results: The results show that the hazard of antipsychotic medication purchases differed between migrant groups, with a higher hazard for migrants from North Africa and the Middle East before socio-economic adjustment (men HR 1.19, 95% CI 1.04-1.37; women HR 1.37, 95% CI 1.12-1.66), and a lower hazard for all migrant groups after adjustment for socio-economic characteristics compared with the Finland-born population. Conclusions: The findings suggest that attention should be paid to the lower use of medication for psychotic disorders in some migrant groups, as well as the potential role of social disadvantage for migrants from North Africa and Middle East.

Antidepressant medication use among working age first-generation migrants resident in Finland: an administrative data linkage study.

BACKGROUND: A higher risk of common mental health disorders has been found for first-generation migrants in high income countries, but few studies have examined the use of mental health care. This study aimed to identify the level of antidepressant use amongst the largest first generation migrant groups resident in Finland. METHODS: This cohort study used record-based data linkage methodology to examine the hazard of antidepressant use between migrant groups in Finland using Cox proportional hazard models. Data was derived using socio-demographic and prescription data from Statistics Finland and the Finnish Population Registry. The cohort included a random sample of 33% of the working age population in 2007 (N = 1,059,426, 49.8% women, 2.5% migrants) and dispensed antidepressant prescriptions from 2008 to 2014. RESULTS: After adjustment for socio-demographic characteristics, results show higher antidepressant use for female migrants from North Africa and the Middle East compared to the Finland-born majority, a similar level of use for migrants from Western countries, and lower use for migrants from other non-Western countries. CONCLUSIONS: The gender and country of origin dependent use of antidepressant medication is discussed in terms of socio-political and cultural between-group differences. Recommendations are made to address inequalities in accessing services, particularly for migrants from non-Western countries.

Developmental trajectories of multisite musculoskeletal pain and depressive symptoms: the effects of job demands and resources and individual factors.

OBJECTIVE: To investigate developmental paths in multisite musculoskeletal pain (MPS) and depressive symptoms (DPS) and the effects of job demands (JD), job resources (JR), optimism and health-related lifestyle on these paths. We expected to find four trajectories--Low Symptoms, High Pain, High Depression and High Symptoms--and hypothesised that high JDs, low JRs, low optimism and adverse lifestyle predict belonging to trajectories with high symptom levels. DESIGN: Data on Finnish firefighters (N = 360) were collected in 1996, 1999 and 2009. The effects of JDs (mental and physical workload), JRs (supervisory relations, interpersonal relations, task resources), optimism and lifestyle (alcohol consumption, smoking, physical exercise, sleeping) on MPS and DPS were assessed. Latent class growth modelling and multinomial logistic regression were applied. RESULTS: Three trajectories emerged: Low Symptoms; High Pain; and High Depression. In a multivariable model, high mental workload (OR 2.9, 95% CI 1.5-5.5), poor interpersonal relations (2.6, 1.4-5.0), sleeping problems (2.7, 1.4-5.2) and low optimism (2.0, 1.0-3.7) predicted belonging to High Depression. Alcohol consumption (2.4, 1.4-4.1) and sleeping problems (2.1, 1.3-3.6) were related to High Pain. CONCLUSIONS: Different developmental paths in MPS and DPS are possible. Partly different factors predict the development of pain and depressive symptoms.

Musculoskeletal pain and depressive symptoms as predictors of trajectories in work ability among finnish firefighters at 13-year follow-up.

OBJECTIVE: To identify work ability trajectories among Finnish firefighters during a 13-year follow-up. We examined whether baseline musculoskeletal pain and depressive symptoms (DPS) predicted membership of the trajectories. METHODS: We studied 411 male firefighters who responded to a questionnaire at both baseline and at least one of two follow-ups. The outcome variable was perceived work ability (0 to 10). The predictors were musculoskeletal and depressive symptoms. Covariates included age, diseases, lifestyle habits, and work-related factors. RESULTS: One fourth of the firefighters belonged to the Diminished work ability trajectory. Musculoskeletal and depressive symptoms, lifestyle risks and diseases, and, in separate analyses, low back pain, were strong predictors of this. CONCLUSIONS: When planning preventive actions and workplace health promotion among firefighters, even one site musculoskeletal pain and mild signs of depression should be taken into account. Prevention of adverse lifestyle habits is also essential.

Positive and negative mood trajectories and their relationship with work ability, self-rated health, and life satisfaction: a 13-year follow-up study.

OBJECTIVE: To investigate the change trajectories of positive and negative moods and their relationship to work ability, self-rated health, and life satisfaction in a three-wave 13-year follow-up study. METHODS: The data, consisting of Finnish firefighters (n = 360), were collected via questionnaires in 1996, 1999, and 2009. RESULTS: Four distinct mood trajectories were identified by latent class growth modeling: (1) high positive, (2) high positive but decreasing, (3) moderately positive, and (4) high negative. The trajectory groups were differentially related to well-being. Members of the high positive trajectory had better well-being than members of other latent mood trajectories. CONCLUSIONS: Different trajectories exist in positive and negative moods, and these trajectories are differentially related to well-being. Developing work environments in which a positive mood can flourish is beneficial in terms of better well-being among employees.

Is work engagement related to work ability beyond working conditions and lifestyle factors?

PURPOSE: To examine the associations of age, lifestyle and work-related factors, and particularly work engagement with the work ability index (WAI) and its sub-dimensions. METHODS: Step-wise regression analysis with a sample of Finnish firefighters (n = 403) was used. The outcome variables were the WAI and its six sub-dimensions. The independent variables consisted of age, lifestyle variables (alcohol consumption, BMI, smoking, physical exercise, and sleep problems), working conditions (job demands, physical workload, supervisory relations, and task resources), and work engagement. The outcome variables and all the variables related to lifestyle, working conditions, and work engagement were measured in 2009. Work ability at baseline 10 years earlier was adjusted for in the models. RESULTS: Work engagement, age, physical exercise, sleep problems, and physical workload were associated with the WAI. All independent variables, except BMI and alcohol consumption, were associated with at least one sub-dimension of the WAI after controlling the baseline WAI. Lifestyle variables, working conditions, and work engagement were more strongly related to the subjective WAI sub-dimensions than to the two more objective WAI sub-dimensions. CONCLUSIONS: Work engagement was significantly associated with work ability even after adjusting for various factors, indicating its importance in promoting work ability. Other key factors for good work ability were frequent exercise, good sleep, non-smoking, low job demands, low physical workload, and high task resources. More specifically, this study suggests that in maintaining work ability, it is valuable not only to promote lifestyle factors or working conditions, but also to enhance employees' positive state of work engagement.