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Original article
Human service work, gender and antidepressant use: a nationwide register-based 19-year follow-up of 752 683 women and men
  1. André Buscariolli1,
  2. Anne Kouvonen1,2,3,
  3. Lauri Kokkinen4,5,
  4. Jaana I Halonen4,
  5. Aki Koskinen4,
  6. Ari Väänänen4,6
  1. 1Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
  2. 2SWPS University of Social Sciences and Humanities, Wroclaw, Poland
  3. 3Administrative Data Research Centre Northern Ireland, Centre for Public Health, Queen’s University Belfast, Belfast, UK
  4. 4Finnish Institute of Occupational Health, Helsinki, Finland
  5. 5Faculty of Social Sciences, University of Tampere, Tampere, Finland
  6. 6School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, UK
  1. Correspondence to Dr Anne Kouvonen, Faculty of Social Sciences, University of Helsinki, Helsinki 00014, Finland; anne.kouvonen{at}


Objectives To examine antidepressant use among male and female human service professionals.

Methods A random sample of individuals between 25 years and 54 years of age (n=752 683; 49.2% women; mean age 39.5 years). Information about each individual’s filled antidepressant prescriptions from 1995 to 2014 was provided by the Social Insurance Institution. First, antidepressant use in five broad human service categories was compared with that in all other occupations grouped together, separately for men and women. Then, each of the 15 human service professions were compared with all other occupations from the same skill/education level (excluding other human services professions). Cox models were applied and the results are presented as HRs for antidepressant use with 95% CIs.

Results The hazard of antidepressant use was higher among men working in human service versus all other occupations with the same skill/occupational level (1.22, 95% CI 1.18 to 1.27), but this was not the case for women (0.99, 95% CI 0.98 to 1.01). The risks differed between professions: male health and social care professionals (including medical doctors, nurses, practical nurses and home care assistants), social workers, childcare workers, teachers and psychologists had a higher risk of antidepressant use than men in non-human service occupations, whereas customer clerks had a lower risk.

Conclusions Male human service professionals had a higher risk of antidepressant use than men working in non-human service occupations. Gendered sociocultural norms and values related to specific occupations as well as occupational selection may be the cause of the elevated risk.

  • mental health
  • epidemiology
  • psychiatry
  • longitudinal studies

Statistics from


  • Contributors AB, AKou, LK, JH, AKos and AKPV conceived and designed the experiments, AB and AKos analysed the data, AKos and AKPV contributed to data collection. AKPV is the guarantor of the study. All authors were involved in writing the paper and approved the submitted and published versions.

  • Funding This study was supported by the Academy of Finland (grant number 267172). AKou was supported by the Economic and Social Research Council (ESRC) (grant number ES/L007509/1) and the Medical Research Council (MRC) (Grant MR/K023241/1). The funders had no role in the data collection, analysis or writing of the paper.

  • Disclaimer The corresponding author (AKou) affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval The Ethics Committee of the Finnish Institute of Occupational Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Because of legal reasons, we are unable to deposit the register data used in the present study with an open data repository. Interested researchers need to obtain these register data directly from the relevant data custodians: the Social Insurance Institution (SII) of Finland and Statistics Finland.

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