Comprehensive Health Research Centre (CHRC), Lisbon Institute of Global Mental Health. Nova Medical School, Nova University of Lisbon. Rua do Instituto Bacteriológico, n°5, 1150-190, Lisbon, Portugal.
Nova Medical School, Nova University of Lisbon. Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal.
BMC Psychiatry. 2020 May 11;20(1):215. doi: 10.1186/s12888-020-02620-1.
Research suggests that economic recessions might be associated with a higher use of psychotropic drugs, but literature is scarce and contradictory in identifying the most vulnerable groups. This study aims to assess possible changes in the use of psychotropic drugs due to the economic recession in Portugal, by comparing self-reported consumption in 2008/09 and 2015/16.
Data from the World Mental Health Survey Initiative Portugal (2008/09) and the National Mental Health Survey Follow-Up (2015/16) were used (n = 911). McNemar's tests were performed to estimate changes in consumption of any psychotropic drug and of antidepressants, anxiolytics, and hypnotics/sedatives. Multiple Generalised Estimating Equations models with interaction effects were used to estimate the population odds of consuming psychotropic drugs according to year, gender and age.
An increase of 6.74% was estimated in the consumption of psychotropic drugs from 2008/09 to 2015/16. Population odds of consuming any psychotropic drugs in 2015/16 were estimated to be 1.5 times higher than in 2008/09 (OR = 1.50;95%CI:1.13-2.01), particularly for hypnotics/sedatives (OR = 1.60;95%CI:1.14-2.25). Women and older individuals presented higher odds of consuming any psychotropic drugs (OR = 2.79;95%CI:2.03-3.84, and OR = 1.80;95%CI:1.28-2.54), after adjusting for year of assessment and education. However, when evaluating the interaction effect of the year with gender and age, men and younger individuals reported higher odds of consuming any psychotropic drugs in 2015/16, when compared to 2008/09 (OR = 1.85;95%CI:1.08-3.17, and OR = 1.95;95%CI:1.32-2.90, respectively).
The findings indicate that the period of economic recession was associated with an increased risk of psychotropic drugs use in Portugal. Consumption of psychotropic drugs remained higher among women and older individuals, but the results suggest that the economic crisis had a disproportionate impact on men and younger individuals. This identification of the most vulnerable population groups is useful to design effective and targeted public health interventions aimed at alleviating the effects of economic recessions.
研究表明，经济衰退可能与精神药物使用增加有关，但文献在确定最脆弱群体方面很少且存在矛盾。本研究旨在通过比较 2008/09 年和 2015/16 年自我报告的消费情况，评估葡萄牙经济衰退对精神药物使用的可能影响。
使用了来自世界心理健康调查倡议葡萄牙（2008/09 年）和国家心理健康调查随访（2015/16 年）的数据（n=911）。采用 McNemar 检验估计任何精神药物和抗抑郁药、抗焦虑药和催眠/镇静剂消费的变化。使用具有交互效应的多个广义估计方程模型来估计根据年份、性别和年龄消费精神药物的人群几率。
从 2008/09 年到 2015/16 年，估计精神药物的消费增加了 6.74%。2015/16 年消费任何精神药物的人群几率估计比 2008/09 年高 1.5 倍（OR=1.50；95%CI：1.13-2.01），特别是催眠/镇静剂（OR=1.60；95%CI：1.14-2.25）。调整评估年份和教育程度后，女性和年龄较大的个体消费任何精神药物的几率更高（OR=2.79；95%CI：2.03-3.84 和 OR=1.80；95%CI：1.28-2.54）。然而，当评估年份与性别和年龄的交互效应时，与 2008/09 年相比，男性和年轻个体在 2015/16 年报告消费任何精神药物的几率更高（OR=1.85；95%CI：1.08-3.17 和 OR=1.95；95%CI：1.32-2.90）。
研究结果表明，经济衰退期间葡萄牙与精神药物使用风险增加有关。精神药物的消费仍然在女性和年龄较大的个体中更高，但结果表明经济危机对男性和年轻个体的影响不成比例。确定最脆弱的人群群体对于设计旨在减轻经济衰退影响的有效和有针对性的公共卫生干预措施很有用。
