Abstract
ObjectiveEstimate the prevalence of psychotropic drugs use in the city of Rio de Janeiro, Brazil, and establish its relationship with the presence of mental disorders.MethodsA probabilistic sample of non-institutionalized individuals, from the general population of Rio de Janeiro (n = 1208;turn out:81%), 15 years or older, who were interviewed using the Composite International Diagnostic Interview 2.1 (depression, anxiety-phobia, OCD\\PTSD, alcoholism sections), and asked about their psychotropic use during a 12 and one-month period before the interview. Data were collected between June/2007-February/2008.The prevalence was estimated with a confidence interval of 95%. The associations between psychotropics use and mental disorders were analyzed through a logistic regression model (Odds Ration – OR).ResultsThe one-month prevalence of psychotropic drug use was 6.55%, 3.19% for men and 9.13% for women. Antidepressants were the most frequently used drug (2.78%), followed by anorectics (1.65%), tranquilizers (1.61%) and mood stabilizers (1.23%). General practitioners issued the highest number of prescriptions (46.3%), followed by psychiatrists (29.3%); 86.6% of the psychotropic drugs used were paid for by the patient himself. Individuals with increased likelihood of using psychotropic drugs were those that had received a psychiatric diagnosis during a one-month period before the study (OR:3.93), females (OR:1.82), separated/divorced (OR:2.23), of increased age (OR:1.03), with higher income (OR:2.96), and family history of mental disorder (OR:2.59); only 16% of the individuals with a current DSM IV diagnosis were using a psychotropic drug; 17% among individuals with a depression-related diagnosis and 8% with Phobic Anxiety Disorders-related diagnosis used psychotropics.ConclusionApproximately 84% of individuals displaying some mental disorder did not use psychotropic drugs, which indicates an important gap between demand and access to treatment. A significant failure is evident in the health system for patients with mental disorders; this could be due to health workers' inability to recognize mental disorders among individuals.
Highlights
The prevalence of psychotropic drug use in the general population varies greatly between countries: 3.5% in England [[1], 6.4% in Chile [2], 7.2% in Canada [3], and 10.6% in Australia [4]
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
We focused on psychotropic use and psychiatric diagnosis one month before the study
Summary
The prevalence of psychotropic drug use in the general population varies greatly between countries: 3.5% in England [[1], 6.4% in Chile [2], 7.2% in Canada [3], and 10.6% in Australia [4]. The European Study of the Epidemiology of Mental Disorders/Mental Health Disability: a European Assessment (ESEMed/MHEDEA 2000) [5], performed in six European countries (Belgium, France, Germany, Italy, the Netherlands and Spain), estimated an annual prevalence of 12.3%. The Medical Expenditure Panel Survey (MEPS) in the US reported annual prevalences of 5.9% in 1996, 7% in 2000, and 8.1% in 2001 [6]. An epidemiological study carried out in Rio de Janeiro by Almeida et al [9] in 1988 in the Governador Island county, estimated a prevalence of 5.2% in psychotropic use. At the beginning of the 90s, Mari et al reported a 12-month prevalence of 10.2% for 4 districts in the city of Sao Paulo [10], and in 1994 Lima et al [11] found an 12-month prevalence of 9.9% in the South of Brazil, among a population of 328,000 inhabitants
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