Estimation of psycholeptic and psychoanaleptic medicine use in an adult general population sample using the Anatomical Therapeutic Chemical classification.
01 Dec 2008-International Journal of Methods in Psychiatric Research (John Wiley & Sons, Ltd.)-Vol. 17, Iss: 4, pp 220-231
TL;DR: It is concluded that considerable proportions of individuals with current PM use exist although lower than may be expected on the basis of the number of Individuals with mental disorder in the general population.
Abstract: Little is known about psycholeptic and psychoanaleptic medicine (PM) use in the general population. This study presents prevalence data about PM use. The sample included 4310 individuals aged 20–79 from a general population health examination in a northern German area (participation proportion: 68.8%; Study of Health in Pomerania, SHIP). Medicines taken during the past seven days were assessed from the medicine packages or self-reports and classified according to the Anatomical Therapeutic Chemical (ATC) classification developed by the World Health Organization. In total, 6.3% of the sample reported PM intake, 8.7% of the women and 4.7% of the men. During the past 12 months prior to the health examination, 49.2% of the individuals with PM use consulted a general practitioner but not a neurologist or a psychiatrist. Among the study participants with PM use, 88.8% had one or more mental disorders during lifetime according to a screening questionnaire. It is concluded that considerable proportions of individuals with current PM use exist although lower than may be expected on the basis of the number of individuals with mental disorder in the general population. Copyright © 2008 John Wiley & Sons, Ltd.
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TL;DR: It is demonstrated that utilization of CDs shows demographical and institutional differences, which could be of help to improve surveillance of CDs as well as to train prescribers and patients.
Abstract: Objective: Use of drugs that may lead to abuse or dependence are subject to controlled prescriptions (CPs) in many countries, and these are closely monitored by health authorities. According to national regulations in Turkey, CPs may be red coloured (RCPs) or green coloured (GCPs). The aim of this study was to evaluate the use of such drugs in Istanbul. Study Design: Retrospective case-control study. Material and Methods: During the study period (01/01-31/12 2009), 502874 CPs were reported. Among these, 4000 CPs each month were randomly selected and evaluated. Results: The majority of GCPs were issued to women (55.6%), while the majority of RCPs were issued to men (68.4%). GCPs were most frequently prescribed by physicians working in private hospitals (33.6%) while RCPs by physicians working in university hospitals (39.7%). GCPs were mostly prescribed by psychiatrists (37.6%) while for RCPs were child and adolescent psychiatrists (35.9%). Psycholeptics (ATC code N05) were the most prescribed controlled drugs (CDs) (43.8%). Methylphenidate (53.9%) was the mostly prescribed on RCPs and alprazolam (39.6%) was on GCPs. Conclusion: We demonstrate that utilization of CDs shows demographical and institutional differences. These data could be of help to improve surveillance of CDs as well as to train prescribers and patients. Turkish Baslik: Kontrole Tabi Ilaclarin Kullanimi: Retrospektif Bir Calisma Anahtar Kelimeler: Kontrole tabi receteler, Kontrole tabi ilaclar, Narkotikler, Psikotrop ilaclar, Kirmizi ve Yesil receteler Amac: Kotuye kullanilma ya da bagimliliga yol acma riski tasiyan ilaclar pek cok ulkede kontrole tabidir ve kullanimlari saglik otoriteleri tarafindan yakindan izlenmektedir. Turkiye'deki ulusal duzenlemelere gore, cogu kontrole tabi ilac (KTI) kirmizi recete (KR) ya da yesil recete (YR) formatinda islem gormektedir. Calismada, Istanbul'da bu formatta islem goren KTI'lerin kullaniminin arastirilmasi amaclanmistir. Gerec ve Yontemler: Calisma periyodu boyunca (01/01-31/12 2009), 502 874 kontrole tabi recete (KTR) Istanbul Saglik Mudurlugu'ne ulastirilmistir. Bu receteler arasindan, her ay icin rastgele secilen 4 000 KTR arastirmada incelenmistir. Bulgular: YR'lerin daha cok kadinlara (%55.6), KR'lerin daha cok erkeklere (%68.4) yazildigi saptandi. YR'lerin en sik ozel hastanelerde (%33.6), KR'lerin en sik universite hastanelerinde (%39.7) yazildigi saptandi. YR'lerin en fazla psikiyatri (%37.6), KR'lerin en fazla cocuk ve ergen psikiyatrisi (%35.9) uzmanlari tarafindan yazdigi saptandi. Psikoleptiklerin (ATC kodu: N05), (%43.8) en cok recetelenen KTI oldugu saptandi. En sik recete edilmis olan KTI'lerin KR'lerde metilfenidat (%53.9), YR'lerde alprazolam (%39.6) oldugu saptandi. Sonuc: KTI kullaniminin demografik ve kurumsal farkliliklar gosterdigi bu arastirmayla ortaya konmus oldu. Bu bilgilerin, KTI takip sistemlerinin gelistirilmesinde ve bu ilaclari yazan ya da kullanan kisilere yonelik etkinliklerde yol gosterici olmasi beklenmektedir.
4 citations
TL;DR: In this paper , the authors analyzed data from three repeated cross-sectional waves (2004, 2008, and 2013) of the Belgian National Health Interview Survey (HIS) and applied multinomial logistic regression to estimate odds in psychotropic drugs use over the observed period.
Abstract: Abstract Background While medicalization and pharmaceuticalization trends of feelings of anxiety and depression have been described in great detail, an empirical examination of these trends is to date lacking. The current study fills this gap in the literature by mapping the use of psychotropic medicines for feelings of anxiety and depression between 2004 and 2013 in Belgium, as well as by examining whether a social gradient might act as a mediator. Methods We analyzed data from three repeated cross-sectional waves (2004, 2008, and 2013) of the Belgian National Health Interview Survey (HIS). Multinomial logistic regression was applied to estimate odds in psychotropic drugs use over the observed period. Results Using an ideal-typical distinction between traditional anxiety drugs (psycholeptics) and depression drugs (psychoanaleptics), we found that treatment methods for feelings of anxiety and depression were converging. Persons having feelings of anxiety consumed less psycholeptic drugs, in favor of psychoanaleptic drugs throughout the observed period. Moreover, these results were partially mediated by educational level. Persons with higher education were less likely to consume psychotropic drugs than those with lower education, suggesting a trend of demedicalization for feelings of anxiety and depression. Limitations Our study observes a limited period, makes use of an ideal typical distinction between psycholeptic and psychoanaleptic drugs, and measurements may be biased by response-bias due to psychotropic drugs use. Conclusion Our study shows that psycholeptics increasingly give way to psychoanaleptics in the treatment of both anxiety and depression, despite several scientists calling their effectiveness for both disorders into question.
References
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TL;DR: The risk factor trends are downwards in most populations but in particular, an increase in smoking in women in many populations and increasing BMI, especially in men, are worrying findings with significant public health implications.
Abstract: d The World Health Organization (WHO) MONICA Project was established to determine how trends in event rates for coronary heart disease (CHD) and, optionally, stroke were related to trends in classic coronary risk factors. Risk factors were therefore monitored over ten years across 38 populations from 21 countries in four continents (overall period covered: 1979-1996). A standard protocol was applied across participating centres, in at least two, and usually three, independent surveys conducted on random samples of the study populations, well separated within the 10-year study period. Smoking rates decreased in most male populations (35-64 years) but in females the majority showed increases. Systolic blood pressure showed decreasing trends in the majority of centres in both sexes. Mean levels of cholesterol generally showed downward trends, which, although the changes were small, had large effects on risk. There was a trend of increasing body mass index (BMI) with half the female populations and two-thirds of the male populations showing a significant increase. s It is feasible to monitor the classic CHD risk factors in diverse populations through repeated surveys over a decade. In general, the risk factor trends are downwards in most populations but in particular, an increase in smoking in women in many populations and increasing BMI, especially in men, are worrying findings with significant public health implications.
175 citations
TL;DR: The CID–S was found to be a time‐efficient diagnostic screening tool for most mental disorders (except for some somatoform and substance use disorders), when used in a two‐stage design with a two to 12 week interval between investigations.
Abstract: This paper introduces the Composite International Diagnostic – Screener (CID–S) for mental disorders, a 12-item self-report questionnaire that is based on core diagnostic questions from the Composite International Diagnostic Interview for the assessment of DSM-IV and ICD-10 disorders (CIDI) for use in two-stage epidemiological designs. Data are reported relating to the performance of the CID–S in a two-stage study of a random sample of 1095 respondents, using a wide range of DSM-IV/CIDI diagnoses (somatoform, anxiety, depressive, other affective, and substance-use disorders). In the first stage, all subjects filled out the screening instrument. Seven to 30 days later trained clinical interviewers administered the computer-assisted full CIDI. The CID–S had an overall sensitivity of 85.3% (range for specific diagnoses 74.7% for alcohol use disorders to 100% for panic disorders) and negative predictive value (NPV) of 92.0% (range 91.0%–100%) for any current (12-month) diagnosis and similar values for lifetime disorders (80.7%, NPV: 85.1%). Likelihood for a DSM-IV diagnosis increased steadily from 10.5% among screen negatives, to 24.9% among those endorsing one screening item to 100% among those endorsing more than eight of the screening items. The performance of the individual CID–S items overall was good, except for three disorders: agoraphobia, somatoform disorders and substance use disorders. Overall, the CID–S was found to be a time-efficient diagnostic screening tool for most mental disorders (except for some somatoform and substance use disorders), when used in a two-stage design with a two to 12 week interval between investigations. Copyright © 1999 Whurr Publishers, Ltd.
143 citations
TL;DR: Concomitant use of analgesics and psychotropics becomes more common with advancing age and is a potential risk factor for adverse drug effects.
Abstract: Aims
To investigate the extent of concomitant use of analgesic and psychotropic medicines among home-dwelling elderly people aged at least 75 years in Finland.
Methods
This was a population-based study in Finland, performed as part of Kuopio 75 + study focusing on the clinical epidemiology of diseases, medication and functional capacity. A random sample of 700 persons was drawn from the total population of the city of Kuopio, eastern Finland, aged 75 years on January 1, 1998 (n = 4518). Ninety-nine persons could not be examined and 78 were living in long-term institutions, so that the number of home-dwelling elderly persons amounted to 523. A trained nurse interviewed the participants about their use of medicines, and a geriatrician examined their overall physical and mental status. Dementia and depression were diagnosed according to the DSM IV criteria. Both regular and irregular prescribed and nonprescribed drug use was recorded.
Results
Every fourth elderly person (27.2%) used analgesics and psychotropics concomitantly, this use becoming twice as common with advancing age (19.6% in the age group 75–79 years, 38.2% among the oldest, aged 85 + years). Concomitant use of psychotropics and opioids also became more common with increasing age (2.8% in age group 75–79 years and 9.6% in the oldest group, aged 85 + years). The use of opioids was nearly twice as common among concomitant users (19.7%) than among those using only analgesics (11.3%). Concomitant users suffered from interfering daily pain and daily pain at rest more commonly than nonusers of analgesics. Depression, sleeping problems and polypharmacy were more common among the concomitant users, who had also had more hip fractures than the rest.
Conclusions
Concomitant use of analgesics and psychotropics becomes more common with advancing age and is a potential risk factor for adverse drug effects.
50 citations
TL;DR: Psychotropic medicine use was congruent with the distribution of related health problems, which means that the least-educated groups in most need of treatment also had the most-frequent medicine use.
Abstract: Objective
To analyse whether the use of different groups of psychotropic medicines among educational groups in a general population was congruent with the occurrence of related diseases.
26 citations
TL;DR: The Epidemiological Society may have grown out of the Statistical Society of London which was formed in 18343 as the two societies had members in common and the first recorded use in English of the new term was in 1850.
Abstract: In 1986 Geoffrey Rose wrote1 ‘If the origin of epidemiology as a branch of medical science were to be given a date it would be 1850. That year saw the first recorded use in English of the new term, which was taken as the title of the “London Epidemiological Society”.’ Rose went on to list the founder members as including William Farr, William Budd, Thomas Addison and John Snow. It is surprising that he omits the name of the Society’s first President, Benjamin Guy Babington, because: ‘When in 1850, on the cessation of the second European visitation of cholera, the Epidemiological Society was first projected, the name of Babington was at once thought of as that of the most fit and efficient leader of the movement.’2 The Epidemiological Society may have grown out of the Statistical Society of London which was formed in 18343 as the two societies had members in common. The Society met first in March 1850 and subsequently in July, under the Chairmanship of Lord Ashley, when Babington was elected President. Benjamin Guy Babington was one of several sons of William Babington who was born in 1755 in Portglenone, Co Antrim where his father, Humphrey, was a Church of Ireland minister.4 A famous ancestor was Anthony, the Architect of the Babington Plot to murder Queen Elizabeth I which was the instrument which brought Mary Queen of Scots to the block. For his part in the Plot, Babington was hung, drawn and quartered in even more than usually barbarous circumstances.5 Another ancestor fought at the Battle of the Boyne. William Babington became Physician to Guy’s Hospital and leader of the profession in London.6 One source states that his son Benjamin was born in Guy’s Hospital in 1794 (hence his middle name) although it seems that William was not appointed there until 1795.7 Benjamin was educated at Charterhouse and then entered the Royal Navy serving at Copenhagen and Walcheren in 1809. After further education he joined the Indian Civil Service where he soon became an accomplished Oriental scholar, translating into English the Tamul (the Dravidian language)—Latin grammar of C J Beschius7 ‘before he had completed his twentieth year’.2 After about 10 years in India his health broke down and he returned to England, already a widower with a family.5 He took up Medicine taking the degree of MB at Pembroke College, Cambridge in 1825 and the full degree of MD in 1830. ‘On the first appearance of epidemic cholera in 1832, he devoted much attention to the investigation of the disease and the following year published a translation from the German of Hecker’s work on the Black Death and other epidemics of the middle ages.’2 In 1837 he was elected Assistant Physician to Guy’s Hospital in preference to Dr Thomas Hodgkin,8 who was later to describe Hodgkin’s disease. In 1840 Babington became a full Physician.7 Babington delivered his inaugural address to the Epidemiological Society on 2 December 1850 in the presence of about 100 members and visitors.9 He described how the Honorary Secretary, Mr Tucker, under the pseudonym ‘Pater’ had written to the Lancet to float the idea of such a Society. The address is masterful, ‘The object of this Society I take to be to endeavour, by the light of modern science, to review all those causes which result in the manifestation and spread of epidemic diseases— to discover causes at present unknown, and investigate those which are ill understood—to collect together facts, on which scientific researches may be securely based—to remove errors which impede their progress—and thus, so far as we are able, having made ourselves thoroughly acquainted with the strongholds of our enemies, and their modes of attack, to suggest © International Epidemiological Association 2001 Printed in Great Britain
17 citations