欧洲精神类药物使用的性别差异：一项大型跨欧洲、基于人群的横断面研究结果。

Gender differences in psychotropic use across Europe: Results from a large cross-sectional, population-based study.

机构信息

École des hautes études en santé publique (EHESP), EA 4057, Paris Descartes University, 75014 Paris, France; Inserm UMR_S1136, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, 75013 Paris, France.

École des hautes études en santé publique (EHESP), EA 4057, Paris Descartes University, 75014 Paris, France; Ghent University, Ghent, Belgium.

出版信息

Eur Psychiatry. 2015 Sep;30(6):778-88. doi: 10.1016/j.eurpsy.2015.05.001. Epub 2015 Jun 4.

DOI:10.1016/j.eurpsy.2015.05.001

PMID:26052073

Abstract

BACKGROUND

In many epidemiological studies, women have been observed to consume psychotropic medication more often than men. However, the consistency of this relationship across Europe, with differences in mental health care (MHC) resources and reimbursement policies, is unknown.

METHODS

Questions on 12-month psychotropic use (antidepressants, benzodiazepines, antipsychotics, mood stabilizers) were asked to 34,204 respondents from 10 European countries of the EU-World Mental Health surveys. Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria were used to determine 12-month prevalence of mood/anxiety disorders using the Composite International Diagnostic Interview (v3.0).

RESULTS

For all participating countries, women were significantly more likely than men to use psychotropic medication within the previous 12 months (overall-OR=2.04, 95% CI: 1.81-2.31). This relationship remained significant after adjusting for common sociodemographic factors (age, income level, employment status, education, marital status) and country-level indicators (MHC provision, private household out-of-pocket expenditure, and Gender Gap Index). In multivariable gender-stratified risk-factor analysis, both women and men were more likely to have taken psychotropic medication with increasing age, decreasing income level, and mental health care use within the past 12 months, with no significant differences between genders. When only including participants with a mental disorder, gender differences overall were still significant with any 12-month mood disorder but not with any 12-month anxiety disorder, remaining so after adjusting for sociodemographic characteristics and country-level indicators.

CONCLUSIONS

Women use psychotropic medication consistently more often than men, yet reasons for their use are similar between genders. These differences also appear to be contingent on the specific mental disorder.

摘要

背景

在许多流行病学研究中，观察到女性比男性更常服用精神药物。然而，在精神卫生保健（MHC）资源和报销政策存在差异的欧洲，这种关系是否一致尚不清楚。

方法

欧盟-世界精神卫生调查的 10 个欧洲国家的 34204 名受访者被问及 12 个月内使用精神药物（抗抑郁药、苯二氮䓬类、抗精神病药、心境稳定剂）的情况。使用复合国际诊断访谈（第 3.0 版），根据《精神障碍诊断与统计手册（第四版）》标准确定 12 个月内心境/焦虑障碍的患病率。

结果

对于所有参与国家，女性在过去 12 个月内使用精神药物的可能性明显高于男性（总体比值比=2.04，95%置信区间：1.81-2.31）。在调整常见社会人口因素（年龄、收入水平、就业状况、教育程度、婚姻状况）和国家层面指标（MHC 供应、私人家庭自付支出和性别差距指数）后，这种关系仍然显著。在多变量性别分层风险因素分析中，随着年龄的增长、收入水平的降低以及过去 12 个月内的精神卫生保健使用，女性和男性都更有可能服用精神药物，两性之间没有显著差异。当仅包括患有精神障碍的参与者时，总体而言，性别差异仍然显著，任何 12 个月的心境障碍都有差异，但任何 12 个月的焦虑障碍没有差异，在调整社会人口特征和国家层面指标后仍然如此。