Disability pension for major depression in Finland

Objective: The authors' goal was to investigate the treatment received befo re receipt of a disability pension for major depression in a representative sample of depressed patients. Method: The medical statements for a random sample of 277 subjects drawn fr om the Disability Pension Register of the Social Insurance Institution were examined. The subjects selected represented individuals in Finland who wer e granted a disability pension because of DSM-III-R major depression during a 12-month period in 1993-1994. Results: For 254 (92%) of the subjects, the statements regarding pension el igibility were written either by a psychiatrist or a psychiatric resident f or patients who were currently being treated in psychiatric settings. There was an additional diagnosis of a comorbid mental disorder or a somatic dis ease contributing to disability in two-thirds of the statements. Overall, t he statements indicated that 242 (87%) of the subjects were prescribed anti depressant medication, but only 24 (9%) received weekly psychotherapy, and only 11 (4%) received ECT. Conclusions: Most subjects granted a disability pension for major depressio n in Finland have comorbid mental or physical disorders contributing to the ir disability. Before receiving their pension, most received antidepressant treatment, but few received the established nonpharmacological treatments.