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移民和芬兰出生者中苯二氮䓬类药物和相关药物的使用:一项基于全国登记的研究。

Use of benzodiazepine and related drugs in migrants and Finnish-born persons: a nationwide register-based study.

机构信息

Finnish Institute for Health and Welfare, Equality Unit, Finland.

University of Helsinki and Helsinki University Hospital; Department of Psychiatry, Finland.

出版信息

Scand J Public Health. 2023 Dec;51(8):1222-1230. doi: 10.1177/14034948221112470. Epub 2022 Jul 25.

DOI:10.1177/14034948221112470
PMID:35876428
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10642218/
Abstract

AIMS

Benzodiazepines and related drugs (BZDR) are often used longer than generally recommended. The aim is to study patterns of use among migrant and Finnish-born users of BZDR, and to identify factors that are associated with long-term use and BZDR polytherapy.

METHODS

This register-based study includes a nationwide sample of migrants (=8729) and their Finnish-born controls (=11 388) who had purchased BZDR in 2011-2014, but not in 2009-2010. Information on drug purchases was obtained from the National Prescription Register and the duration of drug use was estimated using PRE2DUP method. The main outcomes were long-term use of BZDR, polytherapy and time until discontinuation of BZDR use. Sociodemographic variables and information on preceding psychiatric diagnoses were included as covariates. Logistic and Cox regression analyses were the statistical methods used.

RESULTS

Only migrants from Sub-Saharan Africa were more likely to discontinue the medication once initiated than Finnish-born users. Migrants were significantly less likely to be long-term users (adjusted odds ratio 0.79, 95% CI 0.70-0.89) or polytherapy users (aOR 0.90, 95% CI 0.84-0.97) of BZDR compared with Finnish-born participants.

CONCLUSIONS

Migrants had less long-term and concomitant use of several BZDR than Finnish-born participants. The pattern of use is more optimal among migrants, but it may also reflect poorer access to mental health treatment.

摘要

目的

苯二氮䓬类药物和相关药物(BZDR)的使用往往超过一般推荐的时间。本研究旨在研究 BZDR 使用者(包括移民和芬兰出生者)的使用模式,并确定与长期使用和 BZDR 联合治疗相关的因素。

方法

本基于登记的研究包括一个全国性的移民样本(=8729)及其芬兰出生的对照组(=11388),他们在 2011-2014 年购买了 BZDR,但在 2009-2010 年没有购买。药物购买信息来自国家处方登记处,药物使用时间使用 PRE2DUP 方法进行估计。主要结果是 BZDR 的长期使用、联合治疗以及停止使用 BZDR 的时间。将社会人口统计学变量和先前的精神科诊断信息作为协变量。使用逻辑回归和 Cox 回归分析进行统计分析。

结果

只有来自撒哈拉以南非洲的移民在开始用药后停药的可能性高于芬兰出生的使用者。与芬兰出生的参与者相比,移民患者成为 BZDR 的长期使用者(调整后的优势比 0.79,95%置信区间 0.70-0.89)或联合治疗使用者(aOR 0.90,95%置信区间 0.84-0.97)的可能性显著降低。

结论

与芬兰出生的参与者相比,移民患者 BZDR 的长期使用和联合使用较少。这种使用模式在移民中更为理想,但也可能反映出他们获得心理健康治疗的机会较差。

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本文引用的文献

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J Affect Disord. 2022 Feb 15;299:528-535. doi: 10.1016/j.jad.2021.12.071. Epub 2021 Dec 22.
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Depression and anxiety disorders among immigrants living in Finland: Comorbidity and mental health service use.芬兰移民中的抑郁和焦虑障碍:共病和精神卫生服务利用。
J Affect Disord. 2021 May 15;287:334-340. doi: 10.1016/j.jad.2021.03.049. Epub 2021 Mar 23.
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Nonmedical Use of Benzodiazepines among Immigrant and Native-Born Adolescents in Spain: National Trends and Related Factors.西班牙青少年移民与本地青少年的苯二氮䓬类药物非医疗使用:全国趋势与相关因素
Int J Environ Res Public Health. 2021 Jan 28;18(3):1171. doi: 10.3390/ijerph18031171.
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Incidence of and Characteristics Associated With Long-term Benzodiazepine Use in Finland.芬兰苯二氮䓬类药物长期使用的发生率及特点。
JAMA Netw Open. 2020 Oct 1;3(10):e2019029. doi: 10.1001/jamanetworkopen.2020.19029.
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The prevalence of mental illness in refugees and asylum seekers: A systematic review and meta-analysis.难民和寻求庇护者中心理疾病的患病率:系统评价和荟萃分析。
PLoS Med. 2020 Sep 21;17(9):e1003337. doi: 10.1371/journal.pmed.1003337. eCollection 2020 Sep.
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Purchases of psychotropic drugs among the migrant population in Finland: a nationwide register-based cohort study.芬兰流动人口中精神药物的购买情况:一项基于全国登记册的队列研究。
Eur J Public Health. 2020 Dec 11;30(6):1152-1157. doi: 10.1093/eurpub/ckaa117.
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Attitudes towards psychopharmacology and psychotherapy in psychiatric patients with and without migration background.有和没有移民背景的精神科患者对精神药理学和心理治疗的态度。
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First-generation migrants' use of psychotropic medication in Northern Ireland: a record linkage study.北爱尔兰第一代移民使用精神药物情况:一项记录链接研究。
Int J Ment Health Syst. 2019 Dec 28;13:77. doi: 10.1186/s13033-019-0334-3. eCollection 2019.
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Soc Psychiatry Psychiatr Epidemiol. 2020 Apr;55(4):487-496. doi: 10.1007/s00127-019-01774-y. Epub 2019 Sep 21.
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Int Clin Psychopharmacol. 2019 Sep;34(5):211-221. doi: 10.1097/YIC.0000000000000276.