SSRI-use, depression, and socioeconomic status among Norwegian adult women – A cross-sectional study with data from the NOWAC-study

Abstract

<p><i>Introduction -</i> Depressive disorders affect a significant part of the population, and its effects can be debilitating. Such disorders have a higher prevalence among women and previous studies have shown that there is a consistent association between SES and depression, and between SES and SSRI-use. The primary aim of this cross-sectional study was to investigate the association between SES and the use of SSRIs among adult Norwegian women recruited to the NOWAC-study. The association between SES and depression was also explored. SES refers specifically to education and gross household income. <p><i>Methods -</i> Data was provided from the second and third wave of the NOWAC-study with 62 388 participants after exclusion. Descriptive statistics were used to present the prevalence of SSRI-use and depression according to education, income and other health and lifestyle factors. Logistic regression analysis was used to calculate the odds ratios for SSRI-use and depression according to education and income. <p><i>Results -</i> Regarding descriptive statistics, 4.7% reported current use of SSRIs, while the prevalence of current and former depression was 15.5%. In the age-adjusted models the odds of using SSRIs were almost twice as large for the lowest education group (OR 1.95, 95% CI 1.72-2.21) compared to the highest education group (OR 1.15, 95% CI 1.02-1.29), while the odds of using SSRIs were 4.59 times higher for the lowest income group (95% CI 3.87-5.45) compared to the second highest income group (OR 1.15, 95% CI 1.02-1.29). The association between education and depression was considerably less apparent in both models compared to the association between education and SSRI-use. For income, the odds of having depression increased threefold for those in the lowest income group (OR 3.24, 95% CI 2.92-3.61) compared to those in the second highest income group (OR 1.16, CI 95% 1.06-1.27). <p><i>Conclusion -</i> There was a clear inverse social gradient in all outcomes. The association between income and SSRI-use and income and depression was prominent, while the association between education and SSRI-use and education and depression was less apparent.