Abstract
IntroductionUptake of psychotropic medication has been previously used as a proxy for assessing the prevalence of population mental health morbidity. However, it is not known how this compares with estimates derived from population screening tools.ObjectiveTo compare estimates of psychiatric morbidity derived by a validated screening instrument of psychiatric morbidity and a self-reported medication uptake measure.MethodsThis study used data from two recent population-wide health surveys in Northern Ireland, a country (UK) with free health services and no prescription charges. The psychiatric morbidity of 7,489 respondents was assessed using the GHQ-12 and self-reported use of medication for stress, anxiety and depression (sDAS medication).ResultsOverall, 19% of respondents were defined as ‘cases’ and 14.3% were taking sDAS medication. Generally, the two methods identified the same population distributions of characteristics that were associated with psychiatric morbidity though nearly as many non-cases as cases received sDAS medication (46.4% vs. 53.6%). A greater proportion of women and older people were identified as cases according to sDAS medication use, while no such variation was observed between socio-economic status and method of assessment.ConclusionsThis study indicates that these two methods of assessing population psychiatric morbidity provide similar estimates, despite potentially identifying different individuals as cases. It is important to note that different health care systems might be linked to variations in obstacles when accessing and using health care services.HighlightsThere was a reasonable correspondence between the different methods of assessment.A greater proportion of women and older people were identified as cases through the self-reported use of medication.An almost equal amount of GHQ-12 cases and non-cases reported being in receipt of medication.
Highlights
Uptake of psychotropic medication has been previously used as a proxy for assessing the prevalence of population mental health morbidity
A greater proportion of women and older people were identified as cases according to sDAS medication use, while no such variation was observed between socio-economic status and method of assessment
People who presented with psychiatric morbidity were more likely to be female, unmarried, of lower socio-economic status, in poorer physical health and currently smoking
Summary
Uptake of psychotropic medication has been previously used as a proxy for assessing the prevalence of population mental health morbidity. These have been developed from clinical tools and produce assessments for each survey respondent according to the definitions and criteria of ICD-10 and/or DSM-IV [4,5,6] Data produced by these studies are recognised to be of high quality and repetition at regular intervals can produce evidence of temporal trends in psychiatric burden in society [7]. This approach is resource intensive, time-consuming for respondents and requires clinical application or specialist interviewer training [2]. Response rates to general population surveys tend to be moderate and they have been declining over recent decades [14,15]; non-response bias is an ongoing concern and as it is higher amongst young males [16,17], people with lower socio-economic status [18], or residing in urban centres [19], there may be difficulties generalising findings on specific sub-samples to the population as a whole
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