Yeamans Spencer, Carrasco-Garrido Pilar, Hernández-Barrera Valentín, Gil-De-Miguel Ángel
Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
Depress Anxiety. 2025 Aug 15;2025:4661541. doi: 10.1155/da/4661541. eCollection 2025.
Depression is a growing public health problem in the European Union (EU), with many individuals turning to self-medication (SM) to manage their symptoms. This cross-sectional study uses data from the third wave of the European Health Interview Survey (EHIS; 2018-2020) to examine the prevalence and determinants of SM among people with recognized depression and depressive symptoms. A total of 25,701 respondents were analyzed. Prevalence of SM among individuals with recognized depression and symptoms of depression in the EU is 38.46% in men and 46.84% in women, varying considerably between countries. An important finding of this study is the impact of medication availability, with access to over-the-counter (OTC) medications outside of pharmacies nearly doubling SM likelihood (adjusted odds ratio [AOR] = 1.98). Additionally, the results reveal marked differences in how these men and women self-medicate. Specifically, women are more likely to self-medicate with depressive symptoms versus recognized depression (AOR = 1.28), whereas the opposite is observed in men (AOR = 0.69). Among women, younger age groups with depression symptoms are particularly likely to self-medicate (15-24 AOR = 1.60; 25-44 AOR = 1.93) and the results reinforce education as a strong predictor of SM (higher education vs. no education AOR = 5.63). Visits to medical/surgical specialists are also linked to SM in women (AOR = 1.32). This study also highlights potentially concerning relationships between SM and alcohol use in men with recognized depression (AOR = 1.42) and prescribed medicine (AOR = 1.68). Differences are also observable in the effect of employment on SM (AOR = 1.45) in men with depression symptoms and women with recognized depression. In contrast, physical activity (PA; high vs. low AOR = 1.32) and healthcare barriers (distance/transportation issues AOR = 1.89 in women; AOR = 1.55 in men, inability to afford care AOR = 1.38) display similar positive associations in men and women. Taken together, these findings underscore the complex and multifaceted nature of SM and point to potential gaps in depression care across the EU, emphasizing the need for gender-sensitive public health strategies and a closer look at OTC medication access.
抑郁症在欧盟已成为一个日益严重的公共卫生问题，许多人通过自我药疗（SM）来缓解症状。这项横断面研究利用欧洲健康访谈调查（EHIS；2018 - 2020年）第三轮的数据，来研究已确诊抑郁症及有抑郁症状人群中自我药疗的患病率和决定因素。总共对25,701名受访者进行了分析。在欧盟，已确诊抑郁症及有抑郁症状的人群中，男性自我药疗的患病率为38.46%，女性为46.84%，不同国家之间差异很大。这项研究的一个重要发现是药物可得性的影响，在药店以外能获取非处方（OTC）药物会使自我药疗的可能性几乎增加一倍（调整后的优势比[AOR]=1.98）。此外，结果显示这些男性和女性在自我药疗方式上存在显著差异。具体而言，女性出现抑郁症状时比已确诊抑郁症时更倾向于自我药疗（AOR = 1.28），而男性则相反（AOR = 0.69）。在女性中，有抑郁症状的年轻年龄组尤其容易自我药疗（15 - 24岁AOR = 1.60；25 - 44岁AOR = 1.93），结果强化了教育是自我药疗的一个有力预测因素（高等教育与无教育相比AOR = 5.63）。女性看医疗/外科专科医生也与自我药疗有关（AOR = 1.32）。这项研究还突出了在已确诊抑郁症的男性中，自我药疗与饮酒（AOR = 1.42）和处方药（AOR = 1.68）之间可能令人担忧的关系。在有抑郁症状的男性和已确诊抑郁症的女性中，就业对自我药疗的影响也存在差异（AOR = 1.45）。相比之下，身体活动（PA；高强度与低强度相比AOR = 1.32）和医疗保健障碍（女性距离/交通问题AOR = 1.89；男性AOR = 1.55，无力支付医疗费用AOR = 1.38）在男性和女性中显示出类似的正向关联。综上所述，这些发现强调了自我药疗的复杂性和多面性，并指出了欧盟抑郁症护理方面可能存在的差距，强调需要制定对性别敏感的公共卫生策略，并更密切关注非处方药物的获取情况。
