Rouillon F, Blachier C, Dreyfus J P, Bouhassira M, Allicar M P
Service de Psychiatrie du Pr Ades, Hôpital Louis-Mourier, Colombes.
Encephale. 1996 May;22 Spec No 1:39-48.
The objective of this study was to evaluate the mode of prescription and the users of antidepressant agents. It consisted of an initial phase (survey of the general population), aimed at selecting a representative sample of antidepressants users by a mail questionnaire, without asking prescribers in order to avoid the bias inherent to such an approach. Results showed a current incidence of use of 2.75 % for the 8 main antidepressants, i.e. more than one million adults in France. The distribution of antidepressants showed Prozac in first place, followed by Anafranil, and Laroxyl, then Stablon, Athymil, Survector and Ludiomil. In more than 50 % of cases, antidepressants have been taken for a year or more, continuously of intermittently. They were prescribed by a general practitioner in 60 % of cases and a psychiatrist in 30 %. A second survey phase (telephone) undertaken by psychiatrists and involving a sample of this population enabled determination of the pathophysiological profile of consumers at the time of prescription of antidepressant treatment, using a validated diagnostic tool, the MINI. Taking all drugs together, results showed that prescription was within Marketing Authorization approved indications in about 65 % of cases (existence of depression 61 %, dysthymia 3 %, OCD 1 %). This study shows that, in 23 % of cases, antidepressants are not used in patients with one of the psychiatric diseases identified by the MINI but nevertheless suffering from pathophysiological symptoms (subsyndronic syndrome). It can be concluded that, in some subjects, antidepressants are used in non-identified disorders. It must also be recognized that, with 3 % of users, the population of individuals treated by antidepressants is less than that of patients suffering, in the general population, from depression (5 to 10 % per year, according to studies).
本研究的目的是评估抗抑郁药的处方模式及使用者情况。该研究包括初始阶段（对普通人群的调查），旨在通过邮寄问卷选取抗抑郁药使用者的代表性样本，不询问开处方者以避免这种方法固有的偏差。结果显示，8种主要抗抑郁药的当前使用率为2.75%，即在法国有超过100万成年人使用。抗抑郁药的使用分布情况为：百忧解位居榜首，其次是氯米帕明、氟伏沙明，然后是司来吉兰、阿替米林、噻奈普汀和米安色林。在超过50%的病例中，抗抑郁药已连续或间断服用一年或更长时间。60%的病例由全科医生开处方，30%由精神科医生开处方。由精神科医生进行的第二阶段调查（电话调查），涉及该人群的一个样本，使用经过验证的诊断工具MINI，确定了抗抑郁治疗处方时消费者的病理生理特征。综合所有药物来看，结果显示约65%的病例处方符合上市许可批准的适应症（抑郁症占61%，心境恶劣占3%，强迫症占1%）。该研究表明，在23%的病例中，抗抑郁药用于MINI确定的精神疾病患者以外但仍有病理生理症状（亚综合征）的患者。可以得出结论，在一些受试者中，抗抑郁药用于未明确诊断的疾病。还必须认识到，抗抑郁药使用者占总人口的3%，低于普通人群中抑郁症患者的比例（根据研究，每年为5%至10%）。
