Health Department, General Directorate of Health Policy and Planning, Asturias, Spain.
Biostatistics and Epidemiology Platform, Health Research Institute of Asturias, Asturias, Spain.
BMC Public Health. 2023 Mar 15;23(1):494. doi: 10.1186/s12889-023-15360-0.
Spain as multiple other countries has been experiencing an increasing and sustained trend in the use of psychotropic medications since the mid 90s. Recent studies show public health measures implemented to control SARS-Cov2, such as mobility restrictions and the shutdown of nonessential activities increased mental suffering, even contributing to a higher number of anxiety, depression and insomnia disorders that could lead to an increase in the consumption of psychotropics. The aims were: 1) Evaluate the temporal trend in psychotropic consumption by pharmacological subgroup, sex, and age group 2) Estimate the effect of the COVID-19 pandemic in the use of psychotropic drugs.
We conducted a retrospective observational study, retrieving all prescriptions of anxiolytics, hypnotics and sedatives, and antidepressants dispensed in pharmacies of Asturias (Northern Spain) for Primary Care patients for the period 2018-2021. We presented the data expressed in Daily Defined Doses (DDDs) for 1000 persons/day (DHD). To estimate changes in DHDs by year and age group we conducted two multiple linear regressions (one for males and one for females) for every pharmacological subgroup studied. Changes were considered statistically significant when the regression coefficient was p < 0.05. We used the Software R 4.1.0.
For the studied period, the highest DHDs are for antidepressants, although all of the subgroups experienced an increase in consumption rates. Women consumed more psychotropic drugs than men. In 2021, 372 out of every 1000 women were taking daily 1 DDD of these drugs versus 184 out of every 1000 men. Consumption rates for all psychotropic drugs progressively increases with age. Conversely, the biggest increases in consumption were among the youngest age groups (0-14 and 15-29 years) for women, while for men there is more variability. The regression models suggest an upward trend in psychotropic consumption during all the period, especially remarkable from 2020, for both genders and all age groups.
自 90 年代中期以来，西班牙与其他多个国家一样，精神药物的使用呈持续增长趋势。最近的研究表明，为控制 SARS-CoV2 而实施的公共卫生措施，如限制流动和关闭非必要活动，增加了精神痛苦，甚至导致更多的焦虑、抑郁和失眠障碍，从而导致精神药物使用增加。目的是：1）评估按药理学亚组、性别和年龄组划分的精神药物消费的时间趋势；2）估计 COVID-19 大流行对精神药物使用的影响。
我们进行了一项回顾性观察研究，检索了 2018-2021 年阿斯图里亚斯（西班牙北部）初级保健患者在药房开的抗焦虑药、催眠药和镇静剂以及抗抑郁药的所有处方。我们以每 1000 人/天的日剂量定义剂量（DDD）表示数据。为了按年份和年龄组估计 DDD 的变化，我们对每个研究的药理学亚组进行了两次多元线性回归（一次针对男性，一次针对女性）。当回归系数 p<0.05 时，我们认为变化具有统计学意义。我们使用 R 4.1.0 软件。
在所研究的期间，抗抑郁药的 DDD 最高，尽管所有亚组的消费率都有所增加。女性比男性服用更多的精神药物。2021 年，每 1000 名女性中有 372 人每天服用这些药物的 1 DDD，而每 1000 名男性中有 184 人。所有精神药物的消费率随年龄增长而逐渐增加。相反，女性中年龄最小的年龄组（0-14 岁和 15-29 岁）的消费增长率最大，而男性的变化则更为多样。回归模型表明，所有性别和所有年龄组的精神药物消费在整个期间都呈上升趋势，尤其是 2020 年以来更为明显。
