Browsing by Author "Gissler, Mika"
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Item Antidepressant use among immigrants with depressive disorder living in Finland: A register-based study(2022) Kieseppa, Valentina; Markkula, Niina; Heidi, Taipale; Holm, Minna; Jokela, Markus; Suvisaari, Jaana; Tanskanen, Antti; Gissler, Mika; Lehti, VenlaItem Incidence and prevalence of mental disorders among immigrants and native Finns: a register-based study(Springer, 2017) Markkula, Niina; Lehti, Venla; Gissler, Mika; Suvisaari, JaanaPURPOSE: Migrants appear to have a higher risk of mental disorders, but findings vary across country settings and migrant groups. We aimed to assess incidence and prevalence of mental disorders among immigrants and Finnish-born controls in a register-based cohort study. METHODS: A register-based cohort study of 184.806 immigrants and 185.184 Finnish-born controls (1.412.117 person-years) was conducted. Information on mental disorders according to ICD-10 was retrieved from the Hospital Discharge Register, which covers all public health care use. RESULTS: The incidence of any mental disorder was lower among male (adjusted HR 0.82, 95% CI 0.77-0.87) and female (aHR 0.76, 95% CI 0.72-0.81) immigrants, being lowest among Asian and highest among North African and Middle Eastern immigrants. The incidence of bipolar, depressive and alcohol use disorders was lower among immigrants. Incidence of psychotic disorders was lower among female and not higher among male immigrants, compared with native Finns. Incidence of PTSD was higher among male immigrants (aHR 4.88, 95% CI 3.38-7.05). CONCLUSIONS: The risk of mental disorders varies significantly across migrant groups and disorders and is generally lower among immigrants than native Finns.Item Mortality and causes of death among the migrant population of Finland in 2011-2013(European Public Health Association, 2017) Lehti, Venla; Gissler, Mika; Markkula, Niina; Suvisaari, JaanaBackground: Lower mortality among migrants than in the general population has been found in many, but not in all, previous studies. The mortality of migrants has not been studied in Finland, which has a relatively small and recent migrant population. Methods: People who were born abroad and whose mother tongue is not Finnish were identified from the Finnish Central Population Register (n = 185 605). A Finnish-born control matched by age, sex and place of residence was identified for each case (n = 185 605). Information about deaths was collected from the Finnish Causes of Death Register. Cox proportional hazards model was used for assessing the association between migrant status and death in 2011–13. Results: The mortality risk was found to be significantly lower for migrants than for Finnish controls (adjusted hazard ratio 0.77, 95% CI 0.72–0.84), both for migrant men (aHR 0.80, 95% CI 0.73–0.89) and women (aHR 0.78, 95% CI 0.70–0.88). The difference was statistically significant only among people who were not married and among people who were not in employment. There was variation by country of birth, but no migrant group had higher mortality than Finnish controls. No differences in mortality were found by duration of residence in Finland. The higher mortality of Finnish controls was largely explained by alcohol-related conditions and external causes of death. Conclusions: The mortality risk of migrants is lower than of people who were born in Finland. Possible explanations include selection and differences in substance use and other health behaviour.Item Purchases of psychotropic drugs among the migrant population in Finland: a nationwide register-based cohort study(2020) Lehti, Venla; Suvisaari, Jaana; Gissler, Mika; Markkula, NiinaBackground: Migrant populations may have different mental health service needs when compared with native populations. One indicator of service use is the use of psychotropic medication. The aim of this study was to compare the purchases of psychotropic drugs among different migrant populations with the native population in Finland. Methods: Foreign-born participants (n = 184 805) and their Finnish-born controls (n = 185 183) were identified from the Finnish Central Population Register. Information on their purchases of psychotropic drugs in 2011-15 was collected from the National Prescription Register. A washout period of 2009-10 was used to define incident purchases. Cox regression analysis was the statistical method used. Results: At least one incident purchase of a psychotropic drug was identified for 11.1% of migrant women, 11.4% of Finnish-born women, 8.7% of migrant men and 9.8% of Finnish-born men. When controlled for age, sex, marital status, socioeconomic status and social assistance, migrants were less likely to purchase psychotropic drugs (adjusted hazard ratio 0.96, 95% confidence interval 0.93-0.98), but there was variation between different drug categories. Recent migrants and migrants from Asia and Sub-Saharan Africa were least likely to purchase drugs. Migrants from Nordic countries and other Western countries most closely resembled the Finnish-born controls. Conclusions: Recent migrants in Finland appear to use fewer psychotropic drugs than native Finns. It is important to analyze the reasons for this pattern, as they may indicate delays in access to care or benefits. The heterogeneity of migrant populations must also be considered when developing services to better address their needs.