Sihvo Sinikka, Isometsä Erkki, Kiviruusu Olli, Hämäläinen Juha, Suvisaari Jaana, Perälä Jonna, Pirkola Sami, Saarni Samuli, Lönnqvist Jouko
STAKES National Research and Development Centre for Welfare and Health, Helsinki, Finland.
J Affect Disord. 2008 Sep;110(1-2):94-105. doi: 10.1016/j.jad.2008.01.012. Epub 2008 Feb 13.
The aim was to study utilisation patterns and determinants of antidepressant use in the general population >30 years, especially short-term use or use not related to known psychiatric morbidity.
Participants from a cross-sectional population-based Finnish Health 2000 Study (2000--2001) were linked with the National Prescription Register and National Care Register for Health Care. Within a representative sample (N=7112) of the adult population (>30 years), 12-month DSM-IV depressive, anxiety, and alcohol use disorders were assessed with the M-CIDI. Utilisation patterns of antidepressants were categorised to short-term, intermittent and continuous use. Factors predicting short-term use or use not related to known psychiatric morbidity were investigated.
Of Finnish adults 7.1% had used antidepressants in 2000, of which two-thirds reported a physician-diagnosed mental disorder; a third (35%) had major depressive or anxiety disorder during the previous 12 months. In terms of utilisation pattern, 43% were long-term users, 32% intermittent users and 26% short-term users. Short-term use was related to care by a general practitioner and having no known mental disorder. A quarter of all users had no known psychiatric morbidity. This type of user was most common among the older age groups, and inversely related to being single, on disability pension and using mental health services.
Not all psychiatric indications for antidepressant use could be explored.
Depression remains the main indication for antidepressant use. About a quarter of users had no known psychiatric indication and the indication remained unclear. Short-term and non-psychiatric use are more commonly prescribed for the elderly.
本研究旨在探讨30岁以上普通人群中抗抑郁药的使用模式及其影响因素，尤其关注短期用药或与已知精神疾病无关的用药情况。
基于芬兰2000年横断面人群健康研究（2000 - 2001年）的参与者与国家处方登记册和国家医疗保健登记册相链接。在成年人群（>30岁）的代表性样本（N = 7112）中，使用M-CIDI评估12个月内的DSM-IV抑郁、焦虑和酒精使用障碍。抗抑郁药的使用模式分为短期、间歇性和持续性使用。研究预测短期用药或与已知精神疾病无关的用药的因素。
2000年，7.1%的芬兰成年人使用过抗抑郁药，其中三分之二报告有医生诊断的精神障碍；三分之一（35%）在过去12个月内患有重度抑郁或焦虑障碍。就使用模式而言，43%为长期使用者，32%为间歇性使用者，26%为短期使用者。短期用药与全科医生的诊疗以及无已知精神障碍有关。所有使用者中有四分之一无已知精神疾病。这类使用者在老年人群中最为常见，且与单身状态、领取残疾抚恤金和使用心理健康服务呈负相关。
并非所有抗抑郁药使用的精神科指征都能进行探究。
抑郁症仍然是使用抗抑郁药的主要指征。约四分之一的使用者无已知精神科指征，且指征仍不明确。短期和非精神科用药在老年人中更为常见。
