Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
Fam Pract. 2012 Apr;29(2):154-62. doi: 10.1093/fampra/cmr078. Epub 2011 Sep 15.
Mental disorders (MDs) are mainly treated in primary care (PC), where psychotropic drug (PSD) prescribing is highly prevalent. Prescription of PSD is associated with clinical and non-clinical factors.
To describe the patterns of PSD prescribing over a 12-month period and to determine the factors associated with this in a PC population.
Cross-sectional study. Data were collected on 3815 patients, via patient interview, on sociodemographics and MDs [Diagnostic and Statistical Manual of Mental Disorders (DSM-IV criteria)]. Computerized records provided data on PSD prescribing. Multilevel logistic regressions assessed the factors that influence prescribing.
Thirty-four per cent of PC patients were prescribed PSDs >12 months, with anxiolytics being the most commonly prescribed (22%). Fifty-three per cent of patients with any MD in this 12-month period were prescribed PSDs; however, 25% of patients without any of these disorders were also prescribed these medications. Higher rates of prescribing were associated with female gender, older age, presence of MD, being a househusband/housewife, consulting about psychological problems, increasing number of consultations and higher self-perceived disability. PSDs were less likely to be prescribed to patients born outside Spain and those consulting about physical conditions. PSD prescribing was higher in patients previously married and antipsychotic prescribing was higher in patients never married. No statistically significant associations were found between PSD prescription and education.
PSD prescribing rates are high in Catalonia and are associated with a number of clinical and non-clinical factors. A significant proportion of patients are receiving these drugs in the absence of MD. These findings need to be considered when prescribing in PC.
精神障碍（MDs）主要在初级保健（PC）中治疗，其中精神药物（PSD）的处方非常普遍。PSD 的处方与临床和非临床因素有关。
描述在 12 个月期间 PSD 处方的模式，并确定 PC 人群中与该处方相关的因素。
横断面研究。通过患者访谈收集 3815 名患者的社会人口统计学和 MD 数据[《精神障碍诊断与统计手册》（DSM-IV 标准）]。计算机记录提供了 PSD 处方的数据。多水平逻辑回归评估了影响处方的因素。
34%的 PC 患者在 >12 个月内被处方 PSD，其中最常被处方的是抗焦虑药（22%）。在这 12 个月期间有任何 MD 的 53%的患者被处方了 PSD，但 25%的没有这些疾病的患者也被开了这些药物。更高的处方率与女性性别、年龄较大、存在 MD、家庭主妇/主夫、咨询心理问题、咨询次数增加和自我感知残疾程度增加有关。PSD 不太可能被开给出生在西班牙以外的患者和咨询身体状况的患者。在以前结婚的患者中 PSD 处方率较低，在从未结婚的患者中抗精神病药处方率较高。PSD 处方与教育之间没有发现统计学上的显著关联。
在加泰罗尼亚，PSD 的处方率很高，与许多临床和非临床因素有关。相当一部分患者在没有 MD 的情况下接受这些药物。在 PC 中开处方时需要考虑这些发现。
