Occupational class and the changing patterns of hospitalization for affective and neurotic disorders: a nationwide register-based study of the Finnish working-age population, 1976-2010.

PURPOSE: This study aimed to examine the long-term changes and socioeconomic disparities in hospitalization for affective and neurotic disorders among the Finnish working-age population from 1976 to 2010.

METHODS: Register-based study, consisting of a 5-year follow-up of 3,223,624 Finnish working-age (18-64-year old) individuals in seven consecutive cohorts. We calculated the hazard ratios of psychiatric hospitalization for different occupational classes using Cox regression models.

RESULTS: The risk of hospitalization for affective and neurotic disorders increased in all occupational classes after the economic recession in the 1990s, and then decreased in the 2000s. Before the 2000s, the risk was the highest among manual workers. In the 2000s the disparities between upper-level non-manual employees and other occupational classes increased. Hospitalization rates remained high among female manual workers and non-manual lower-level employees.

CONCLUSIONS: This study revealed important similarities and differences between occupational classes in terms of long-term changes in hospitalization for affective and neurotic disorders. The results suggest that the labor market changes and healthcare reforms during the 1990s and 2000s in Finland have been more beneficial for higher than for lower occupational classes.