Hospital Universitário, Universidade de São Paulo, São Paulo, Brasil.
J Affect Disord. 2013 Oct;151(1):71-7. doi: 10.1016/j.jad.2013.05.054. Epub 2013 Jun 12.
Antidepressant and benzodiazepine medicines are widely prescribed in high-income countries. Our aim was to investigate and describe clinical and demographic characteristics of their use in a large cohort from a middle-income country.
Participants (n=15,105) from the Brazilian Health Longitudinal Study (ELSA-Brasil), a civil servant cohort from six different sites in Brazil were asked about antidepressant and benzodiazepine use. The Clinical Interview Schedule-Revised was used for psychiatric assessment. Sociodemographic and clinical data were also collected.
Current use of antidepressant and benzodiazepine medicines was respectively reported by 6.87% and 3.88% of participants. These numbers were higher in major depression-MDD (16.5% and 13.9%), generalized anxiety disorder-GAD (14% and 9.5%) and any mental disorder (11.7% and 7.8%). The use of antidepressant and benzodiazepine was directly associated with clinical comorbidities and psychiatry diagnosis. In addition, older age was associated with benzodiazepine use and more years of schooling, with antidepressant use. Finally, the use of these medicines was strongly associated (odds ratio=8.48, p<0.001).
Our cohort does not include younger adults (18-34 years), although it includes older (65-75 years) participants.
Antidepressant and benzodiazepine use in Brazil is lower than in high-income countries. We found that factors such as age and education level were associated with the use of these medicines, whereas MDD and GAD were poor predictors of psychopharmacotherapy use, suggesting misuse/overuse of psychopharmacotherapy among individuals without psychiatric illness and underuse among those with psychiatric conditions in Brazil.
抗抑郁药和苯二氮䓬类药物在高收入国家广泛使用。我们的目的是调查和描述来自中低收入国家的大型队列中它们的使用情况及其临床和人口统计学特征。
巴西卫生纵向研究（ELSA-Brasil）的参与者（n=15105）是来自巴西六个不同地点的公务员队列，询问了他们使用抗抑郁药和苯二氮䓬类药物的情况。使用临床访谈量表修订版进行精神科评估。还收集了社会人口统计学和临床数据。
目前使用抗抑郁药和苯二氮䓬类药物的参与者分别占 6.87%和 3.88%。在重度抑郁症（MDD）（16.5%和 13.9%）、广泛性焦虑症（GAD）（14%和 9.5%）和任何精神障碍（11.7%和 7.8%）中，这些数字更高。抗抑郁药和苯二氮䓬类药物的使用与临床合并症和精神科诊断直接相关。此外，年龄较大与苯二氮䓬类药物的使用相关，而受教育年限较长与抗抑郁药的使用相关。最后，这些药物的使用具有很强的相关性（比值比=8.48，p<0.001）。
我们的队列不包括年轻人（18-34 岁），尽管包括年龄较大的参与者（65-75 岁）。
巴西抗抑郁药和苯二氮䓬类药物的使用低于高收入国家。我们发现，年龄和教育水平等因素与这些药物的使用有关，而 MDD 和 GAD 对抗抑郁药治疗使用的预测能力较差，这表明在没有精神疾病的个体中存在精神药物的误用/滥用，以及在有精神疾病的个体中使用不足。
