Open Access Highly Accessed Research article

Living alone and antidepressant medication use: a prospective study in a working-age population

Laura Pulkki-Råback12*, Mika Kivimäki13, Kirsi Ahola1, Kaisla Joutsenniemi4, Marko Elovainio4, Helena Rossi1, Sampsa Puttonen12, Seppo Koskinen4, Erkki Isometsä45, Jouko Lönnqvist45 and Marianna Virtanen1

Author affiliations

1 Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland

2 Unit of Personality, Work and Health Psychology, Institute of Behavioral Sciences, University of Helsinki, P.O. Box 9, 00014 Helsinki, Finland

3 Department of Epidemiology and Public Health, University College London, 1-9 Torrington Place, WC1E 6BT London, UK

4 National Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland

5 Department of Psychiatry and Helsinki University Central Hospital, University of Helsinki, P.O. Box 20, 00014 Helsinki, Finland

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Citation and License

BMC Public Health 2012, 12:236  doi:10.1186/1471-2458-12-236

Published: 23 March 2012

Abstract

Background

An increasing proportion of the population lives in one-person households. The authors examined whether living alone predicts the use of antidepressant medication and whether socioeconomic, psychosocial, or behavioral factors explain this association.

Methods

The participants were a nationally representative sample of working-age Finns from the Health 2000 Study, totaling 1695 men and 1776 women with a mean age of 44.6 years. In the baseline survey in 2000, living arrangements (living alone vs. not) and potential explanatory factors, including psychosocial factors (social support, work climate, hostility), sociodemographic factors (occupational grade, education, income, unemployment, urbanicity, rental living, housing conditions), and health behaviors (smoking, alcohol use, physical activity, obesity), were measured. Antidepressant medication use was followed up from 2000 to 2008 through linkage to national prescription registers.

Results

Participants living alone had a 1.81-fold (CI = 1.46-2.23) higher purchase rate of antidepressants during the follow-up period than those who did not live alone. Adjustment for sociodemographic factors attenuated this association by 21% (adjusted OR = 1.64, CI = 1.32-2.05). The corresponding attenuation was 12% after adjustment for psychosocial factors (adjusted OR = 1.71, CI = 1.38-2.11) and 9% after adjustment for health behaviors (adjusted OR = 1.74, CI = 1.41-2.14). Gender-stratified analyses showed that in women the greatest attenuation was related to sociodemographic factors and in men to psychosocial factors.

Conclusions

These data suggest that people living alone may be at increased risk of developing mental health problems. The public health value is in recognizing that people who live alone are more likely to have material and psychosocial problems that may contribute to excess mental health problems in this population group.

Keywords:
Mental health; Antidepressant medication; Living arrangement; Psychosocial factors; Socioeconomic