Abstract
Background:The increased use of antidepressant drugs (ADs) improved the response to the needs of care although some community surveys have shown that subjects without lifetime psychiatric diagnosis (anxiety/depression) used ADs.Objectives:To evaluate the appropriateness and amount of prescription of psychotropic drugs in people with lifetime diagnosis of Major Depressive Disorder (MDD) by means of community survey with a semi-structured interview as a diagnostic instrument, administered by clinicians.Methods:Study design: community survey.Study population: samples randomly drawn, after stratification from the adult population of municipal records. Sample size: 4.999 people were drawn in 7 centres of 6 Italian regions.Tools:questionnaire on psychotropic drug consumption, prescription, health services utilization; Structured Clinical Interview for DSM-IV modified (ANTAS); Training: interviewers were trained psychologists or medical doctors.Results:3.398 subjects were interviewed (68% of the recruited sample). The lifetime prevalence of DSM-IV MDD was 4.3% in males and 11.5% in females; antidepressant drugs were taken by 4.7% of subjects, 2.9% male and 5.9% female. 38% of males and 57% of females with lifetime diagnosis of MDD were taking ADs. Conclusions:Compared with studies using lay interviewers and structured tools the prevalence of the MDD was quite lower; ADs use was higher and tallied well with the data regarding antidepressant sales in Italy; the correspondence between lifetime diagnosis of MDD and ADs use was closer.
Highlights
Direct expenditure for antidepressant drugs (ADs) in Italy incremented at a 25% rate from 2000 to 2002 [1]
For more than a decade (1991 to 2002), in a community repeated survey performed in the Italian region of Sardinia, the number of individuals with a defined diagnosis of depression while taking ADs, increased from 8% to 40% [2]
As for a diagnostic instrument, we use a tool derivate from defined and validated international semi-structured interviews that are administered by expert clinicians. In this first report we present the data among the lifetime prevalence of major depressive disorders
Summary
A number of population surveys have shown that the ADs usage increase is associated with an improved response to patients’ needs of those diagnosed with depression. For more than a decade (1991 to 2002), in a community repeated survey performed in the Italian region of Sardinia, the number of individuals with a defined diagnosis of depression while taking ADs, increased from 8% to 40% [2]. The proportion of adults in the community who took antidepressants was 4.2% in 2002. A relevant proportion of subjects without lifetime. The increased use of antidepressant drugs (ADs) improved the response to the needs of care some community surveys have shown that subjects without lifetime psychiatric diagnosis (anxiety/depression) used ADs
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