Research Group on Statistics, Econometrics and Health (GRECS), Universitat de Girona, Girona, Spain.
CIBER of Epidemiology and Public Health, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
BMJ Open. 2019 Jan 22;9(1):e021440. doi: 10.1136/bmjopen-2017-021440.
Although psychotropic drugs are used to treat mental health disorders, little evidence analyses the effects the 2008 economic downturn had on psychotropic drug consumption in the case of Spain. We analyse these effects, considering both gender and employment situation.
We used the microdata from the face-to-face cross-sectional population-based Spanish National Health Survey for two periods: 2006-2007 (n=28 954) and 2011-2012 (n=20 509). Our samples included adults (>15 years old).
The response variables are consumption (or not) of antidepressants or sedatives and the explanatory variables are the year of the survey, gender and employment status. Covariates are mental health problems, mental health index General Health Questionnaire (GHQ-12) and self-reported health outcome variables such as self-rated health, chronic diseases, smoking behaviour, sleeping hours, body mass index, physical activity in the workplace, medical visits during the past year, age, region of residence (autonomous communities), educational level, marital status and social class of the reference person. Finally, we include interactions between time period, gender and employment status. We specify random effects logistic regressions and use Bayesian methods for the inference.
The economic crisis did not significantly change the probability of taking antidepressant drugs (OR=0.56, 95% CI 0.18 to 2.56) nor sedatives (OR=1.21, 95% CI 0.26 to 5.49). In general, the probability of consuming antidepressants among men and women decreases, but there are differences depending on employment status. The probability of consuming sedatives also depends on the employment status.
While the year of the financial crisis is not associated with the consumption of antidepressants nor sedatives, it has widened the gap in consumption differences between men and women. Although antidepressant use dropped, the difference in consumption levels between men and women grew significantly among the retired, and in the case of sedatives, risk of women taking sedatives increased in all groups except students.
虽然精神药物被用于治疗精神健康障碍，但很少有证据分析 2008 年经济衰退对西班牙精神药物消费的影响。我们分析了这些影响，同时考虑了性别和就业情况。
我们使用了来自 2006-2007 年（n=28954）和 2011-2012 年（n=20509）面对面的基于人群的西班牙国家健康调查的微观数据。我们的样本包括成年人（>15 岁）。
因变量是抗抑郁药或镇静剂的使用（或不使用），解释变量是调查年份、性别和就业状况。协变量是心理健康问题、心理健康指数一般健康问卷（GHQ-12）以及自我报告的健康结果变量，如自我评估的健康状况、慢性疾病、吸烟行为、睡眠时间、体重指数、工作场所的身体活动、过去一年的医疗访问、年龄、居住地区（自治区）、教育水平、婚姻状况和参考人的社会阶层。最后，我们包括了时间段、性别和就业状况之间的相互作用。我们指定了随机效应逻辑回归，并使用贝叶斯方法进行推断。
经济危机并没有显著改变服用抗抑郁药（OR=0.56，95%CI 0.18 至 2.56）或镇静剂（OR=1.21，95%CI 0.26 至 5.49）的概率。一般来说，男性和女性服用抗抑郁药的概率都有所下降，但根据就业状况存在差异。服用镇静剂的概率也取决于就业状况。
虽然金融危机的年份与抗抑郁药或镇静剂的消费无关，但它扩大了男性和女性消费差异的差距。尽管抗抑郁药的使用量有所下降，但在退休人员中，男性和女性之间的消费水平差异显著增加，而在镇静剂方面，除了学生之外，所有群体的女性服用镇静剂的风险都有所增加。
