Consumption Of Psychiatric Drugs Research Articles

Risk factor analysis of omicron patients with mental health problems in the Fangcang shelter hospital based on psychiatric drug intervention during the COVID-19 pandemic in Shanghai, China.

The widespread coronavirus disease 2019 (COVID-19) outbreak impacted the mental health of infected patients admitted to Fangcang shelter hospital a large-scale, temporary structure converted from existing public venues to isolate patients with mild or moderate symptoms of COVID-19 infection. This study aimed to investigate the risk factors of the infected patients from a new pharmacological perspective based on psychiatric drug consumption rather than questionnaires for the first time. We summarised the medical information and analysed the prevalence proportion, characteristics, and the related risk factors of omicron variants infected patients in the Fangcang Shelter Hospital of the National Exhibition and Convention Center (Shanghai) from 9 April 2022 to 31 May 2022. In this study, 6,218 individuals at 3.57% of all admitted patients in the Fangcang shelter were collected suffering from mental health problems in severe conditions including schizophrenia, depression, insomnia, and anxiety who needed psychiatric drug intervention. In the group, 97.44% experienced their first prescription of psychiatric drugs and had no diagnosed historical psychiatric diseases. Further analysis indicated that female sex, no vaccination, older age, longer hospitalization time, and more comorbidities were independent risk factors for the drug-intervened patients. This is the first study to analyse the mental health problems of omicron variants infected patients hospitalised in Fangcang shelter hospitals. The research demonstrated the necessity of potential mental and psychological service development in Fangcang shelters during the COVID-19 pandemic and other public emergency responses.

Consumption of Psychiatric Drugs in Primary Care during the COVID-19 Pandemic.

Background: The main objective of this research was to analyze whether there were changes in the use of antidepressants, anxiolytics, and hypnotic-sedative drugs, in the context of primary health care, during the COVID-19 pandemic compared to the pre-pandemic period. We further sought to study consumption in vulnerable population groups. Methods: A cross-sectional observational study was performed in a primary health district of Spain. The data were obtained from the Andalusian Public Health System database, for the pre-COVID-19 period, from March 2019 to February 2020, and for the COVID-19 period, from March 2020 to February 2021. Univariant and bivariant analyses were performed. The effect size was measured using the Rosenthal test. Results: While the total number of medical prescriptions decreased by 2.5% in the COVID-19 period, the prescriptions of psychiatric drugs increased by 6.1%. The increase in the dose consumption per 1000 inhabitants (DHD) was highest for anxiolytics (7.2%), followed by hypnotic-sedatives (5.6%) and antidepressants (3.7%). The consumption of antidepressants, anxiolytics, and sedative-hypnotic drugs was higher in women, older people, and rural areas and lower in areas with social transformation needs, with these differences being statistically significant. Conclusions: The consumption of psychiatric drugs has increased over the COVID-19 pandemic, especially in women, older people, and rural areas. Thus, we should reflect on the adequate use of these drugs.

Health inequalities between male and female immigrants in Spain after the beginning of the economic crisis.

The aim of this study was to analyse health inequalities in the immigrant population in Spain in 2014, while differentiating between immigrant and native-born men and women. We have designed a cross-sectional study on the population aged over 15years resident in Spain and the data were obtained from the 2014 European Health Survey in Spain (n=22,842). Among immigrant men and women, we observed a lower risk of having a Chronic Physical Problem (CPP) or a Mental Health Problem (MHP) and a lower consumption of psychiatric drugs. We also observed a higher risk of lack of medical care in immigrant men compared to native-born. The country of origin was not significantly related to self-perception of health or use of Primary Care (PC) and Emergency Care services. In conclusion, we observed that now that the peak of the crisis has passed it seems that the "healthy immigrant" effect is being recovered, although the gender inequalities observed in the general population are transferred to the immigrant population. We need to approach the feminisation of migration from a new perspective and understand how inequalities affect immigrant women.

Concomitant Drug Use in Patients on Methadone Maintenance Therapy

Background: Methadone maintenance therapy (MMT) is considered as an efficient and effective treatment in management of high risk opioids addiction; although, concomitant use of other drugs may interfere with treatment course and outcome in MMT cases. This study aimed at evaluating patterns of drug use along with methadone based on self reported and urine analysis data in two MMT clinics. Methods: 135 patients on MMT recruited for this cross-sectional study which was conducted from March to September 2014. Data were obtained of MMT clinic of Imam Reza (p) hospital, Mashhad, Iran. After completing a written informed consent, a questionnaire including demographic information, duration of MMT, methadone dose, concomitant medication and other related information was fulfilled. Data were analyzed by SPSS software version 16. Results: Mean (SD) age of patients was 42.8 (12.2). All patients were taking medication along with methadone. The most prevalent drug classes were antidepressants (32%) and benzodiazepines (BNZD) (25%). The next three drug groups were analgesics, GI and cardiovascular drugs respectively. Antidepressant and benzodiazepine use was more prevalent in patients who were on MMT for at least 7 months compared with shorter courses. Antidepressant use was more common in patients on maximum dose of 30 mg/day methadone while BNZD use was more frequent in patients on doses higher than 30 mg/d. Conclusion: Psychiatric drug use is common in opioid addicted cases. BNZD and antidepressant drugs were two most consumed drugs in cases on MMT based on our study. Psychiatric drug consumption was more common in patients on higher length of methadone use. Dosage of methadone may affect kind of concomitant drug use. Physicians should be aware of interactions between psychiatric medications and opioids.

Psychiatric Drug Consumption Among Multiple Sclerosis Patients Before and After Disability Pension; a Controlled Register Study

Introduction Many multiple sclerosis (MS) patients suffer from psychiatric comorbidity, and 60% of patients of working age are on disability pension (DP). It is unknown how transition to DP affects MS patients’ mental health. Objectives To investigate the risk for being prescribed psychiatric drugs before and after receiving full-time DP in MS patients compared to matched controls. Aims To examine the impact of transition of DP on MS patients' mental health. Methods Nationwide Swedish registers were used to identify all 3836 MS patients who were granted full-time DP in 2000-2012, along with 19,180 propensity matched controls also being granted DP in the same years. Patients and controls were organized into cohorts by year of DP, and adjusted odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated for being prescribed Selective Serotonine Reuptake Inhibitors (SSRIs), benzodiazepines and sleeping agents in 2006. Results The risk for being prescribed psychiatric drugs increased in the years leading up to DP among both MS patients and controls. After DP, the risk for benzodiazepines increased among MS patients but was unchanged among controls (OR 1.72, 95%CI 1.16-2.57). MS patients had an increased risk for SSRIs after DP compared to controls (OR 1.76, 95%CI 1.44-2.15). Conclusions The risk for being prescribed psychiatric drugs after DP differs substantially between MS patients and other DP diagnoses. Possible reasons for the increased psychiatric illness among MS patients during and after transition to DP should be further investigated, as well as the role of DP as a rehabilitory measure.

Consumption of psychiatric drugs by patients of medical and surgical clinics in a general hospital

to identify the prevalence of the use of psychiatric drugs among patients admitted to medical and surgical clinics of a general hospital, and also the factors related to the consumption of this type of medication. this is a transversal, descriptive, correlational study with quantitative analysis. For the collection of data, there was use of structured interviews and also reference to medical files. there was confirmation of a high prevalence of users of psychiatric drugs, which was associated to the female sex, to people who do not practice Roman Catholicism, and admittance to the clinic not covered by the Single Health System (Sistema Único de Saúde - SUS), as well as the presence of common mental disorders. Benzodiazepine drugs were the most commonly used psychiatric drugs. Among the total number of users, there has been the identification of patients who were not aware that they were receiving such medication. Doctors who are not psychiatrists were responsible for most prescriptions of psychiatric drugs. this signals the need to prepare health professionals to deal with psychological and social problems commonly found in clinical practice, in order to promote the rational use of psychiatric drugs.

P-235 - Evaluation of psychiatric illness in iranian stoma patients

The objective of this study was to assess the nonpsychotic psychiatric disorders of stoma patients in Iran. In this cross-sectional study, patients referred to the Iranian Ostomy Association from 2005 to 2006 filled the 28-item General Health Questionnaire (GHQ) in Farsi as a screening instrument to identify cases of nonpsychotic psychiatric morbidity. A total of 155 patients participated in the study, of whom 79 (51%) were female and 76 (49%) were male. Fifty-five percent of the patients (n = 86) had psychiatric problems. The females' mean GHQ score was significantly higher than that of males (P = .001). Psychiatric disorder was significantly more frequent among patients with the following specifications: educational level of high school or lower (P = .001), mucosal hemorrhage of the ostomy (P = .03), stomal stenosis (P = .012), and history of psychiatric drug consumption (P = .000). GHQ score decreased as stoma age increased (P = .032; r = -.177). Similar to other complications, psychiatric problems are prevalent in Iranian stoma patients. Our findings highlight the need for special support.

P02-450 - Pharmacoepidemiologic studies on psychiatric drugs use in Serbia

High rate of prescribing of psychiatric drugs causes medical, social and economic consequences.This research was performed by collecting and analysing all the papers published on this matter in Serbia.In former Yugoslavia (of which Serbia was a constitutive republic), during the eighties, a study of benzodiazepines use showed a trend of the increase of their use (17,9 defined daily doses - DDDs in 1983 - 22,3 DDDs in 1988) (Macolic V et al. Benzodiazepines utilization in Yugoslavia 1983–1988. Pharmaca 1990;217–97). Similar trends continued in the nineties. In 1994 diazepam was at the first position on the list of most prescribed drugs (Miljković M. et al. Analysis of Drug Utilization in Serbia During the Years 1996 and 1997. Pharmacoepidemiol Drug Saf 2000;9:59–64.). The analysis of the trend of prescribing of psychiatric drugs in Serbia (2000–2004) shows the increase, with the emphasis on the use of benzodiazepines and antidepressants (Divac N. et al. Trends in consumption of psychiatric drugs in Serbia and Montenegro 2000–2004. Pharmacoepidemiol Drug Saf. 2006;15:835–8.). There are also positive, qualitative changes in the prescribing practice: the increase of the use of SSRI antidepressants and atypical antipsychotics. Specific prescribing habits were noticed: the common practice of polypharmacy in the treatment of psychoses (Divac N. et al. Antipsychotic polypharmacy at the University Psychiatric Hospital in Serbia. Pharmacoepidemiol Drug Saf. 2007;16:1250–1.).Pharmacoepidemiologic methods have found its place in Serbian science. The methodology used in these studies is mostly up-to-date. Main limitation of these studies is the lack of databases.

Evaluation of psychiatric illness in Iranian stoma patients

Introduction The objective of this study was to assess the nonpsychotic psychiatric disorders of stoma patients in Iran. Method In this cross-sectional study, patients referred to the Iranian Ostomy Association from 2005 to 2006 filled the 28-item General Health Questionnaire (GHQ) in Farsi as a screening instrument to identify cases of nonpsychotic psychiatric morbidity. Results A total of 155 patients participated in the study, of whom 79 (51%) were female and 76 (49%) were male. Fifty-five percent of the patients ( n=86) had psychiatric problems. The females' mean GHQ score was significantly higher than that of males ( P=.001). Psychiatric disorder was significantly more frequent among patients with the following specifications: educational level of high school or lower ( P=.001), mucosal hemorrhage of the ostomy ( P=.03), stomal stenosis ( P=.012), and history of psychiatric drug consumption ( P=.000). GHQ score decreased as stoma age increased ( P=.032; r=−.177). Discussion Similar to other complications, psychiatric problems are prevalent in Iranian stoma patients. Our findings highlight the need for special support.

Trends in consumption of psychiatric drugs in Serbia and Montenegro 2000–2004

To investigate the trends in psychiatric drugs utilization in Serbia and Montenegro over the 5-years period (2000-2004). The wholesale data issued by the manufacturers or distributors were used. Also, the lists of drugs used from the Institute of Mental Health (institution which provides primary, secondary and tertiary psychiatric care) were used to corroborate the wholesale data. The utilization of drugs in general population was calculated using ATC/DDD methodology, and was expressed in Defined Daily Doses (DDD) per 1000 inhabitants per day. The utilization of drugs in the Institute of Mental Health was calculated from the hospital pharmacy records and was expressed as the number of DDDs per 100 bed-days. The statistics was performed using standard statistical methods. The general consumption of psychiatric drugs in Serbia and Montenegro significantly increased during the 2000-2004 period (from 45.1 DDD/1000 inhabitants/day in 2000 to 69.1 DDD/1000 inhour/day in 2004). The general utilization of anxiolytic/hypnotic drugs surged significantly, but the inhospital use remained rather stable. The most prominent changes were noted in the utilization of antidepressants, which doubled in that period, both in general and inhospital settings. Among antipsychotics in general population, there is a significant increase in the utilization of clozapine. In inhospital setting, there is a significant increase of total utilization of antipsychotic drugs, but this is also mainly on the account of atypicals. The total consumption of psychiatric drugs significantly increased. The utilization of anxiolytic/hypnotic drugs in 2004 reached 60 DDDs/1000 inhabitants/day, which is in collision with the trend in developed countries. It is necessary to form national guidelines for prescribing anxiolytic/hypnotic drugs, in order to rationalize their use. More favourable is the antidepressant (SSRIs in particular) and atypical antipsychotic drugs utilization increase.

Ansiedad ante la muerte en atención primaria: relación con la frecuentación y la psicomorbilidad de los consultantes

To calculate the prevalence of psychological morbidity and anxiety about death among patients. To observe the association of these variables with the presence of chronic illness, consumption of psychiatric drugs and frequency of attendance. Cross-sectional, descriptive study. Semi-urban primary care centre. The study was proposed to 281 patients and accepted by 226 over 18 years old, selected systematically from among 1829 people who attended for consultation between May and July 1999. We calculated 30% prevalence of psychological morbidity. Face-to-face Interviews and questionnaires using the Goldberg Anxiety and Depression scales and Templer's scale of Anxiety about death. 63.7% women and 36.3% men responded, with an average age of 52.2 (SD 16.2). Positive Anxiety and Depression scale (prevalence of psychological morbidity) 55.3%; 61.8% in women and 43.9% in men (p = 0.009). Mean score on scale of anxiety about death 6.08 (SD 3.15); 6.66 in women (SD 2.67) and 5.05 in men (SD 2.67) (p < 0.0005). In over-attenders, anxiety about death was 6.61 (SD 3.23); and in those who are not, 5.81 (SD 3.10) (p = 0.074). The group with psychiatric morbidity had 38.4 mean visits (SD 27.28) against 35.5 (SD 22.59) for those without psychiatric morbidity (NS). In patients with psychiatric morbidity, the mean on the scale of anxiety about death was 7.51 (SD 3.33); and 5.33 (2.65) in patients without it (p < 0.0005). High prevalence of psychiatric morbidity. The majority are women, who have a mean value of anxiety about death which is greater than men's. We found no association between anxiety about death and over-attendance. The patients with psychiatric morbidity are more anxious about death. Chronic illness, age and consumption of psychiatric drugs are linked to a greater use of the clinic. We only found a relationship between psychiatric morbidity and a greater demand for health-care among the over-70s.

Enfermos crónicos domiciliarios y consumo de psicofármacos

To assess the consumption of psychiatric drugs by chronic homebound patients. Descriptive, longitudinal study. Raval Nord Health District, Barcelona. All 243 chronically ill homebound patients registered on the home care programme in May 1996. After three years 16% had gone into a home, 9% had moved residence, 38% had died, and 37% remained active. Of the 90 patients still active, 40% took some psychiatric drug in May 1999. 8% of the patients who said they had taken psychiatric drugs did so by self-medication. The most commonly consumed pharmacological group of the psychiatric drugs were benzodiazepines at 64%. Women took more psychiatric drugs (45%), as did persons living alone or who had been bereaved (50%). The proportion of patients taking psychiatric drugs was greater when there was worse autonomy according to the Katz index (67%), a cognitive deficit on the Short Portable Mental Status Questionnaire (SPMSQ) of Pfeiffer (62%), and in the presence of comorbidity (56%) (p < 0.01). There is high consumption of psychiatric drugs by chronic homebound patients, especially when there is physical-cognitive deterioration and presence of comorbidity.

Enfermos crónicos domiciliarios: valoración integral físico-cognitiva y caídas durante 3 años de seguimiento

To assess the physical and cognitive capacity of chronically ill homebound patients, and the falls they suffered during three years of monitoring. Descriptive, longitudinal study. "Raval Nord" Health District, Barcelona. All the 243 homebound chronic patients registered in the home care programme in May 1996 (67% women, average age 84). After three years 16% had gone into an old people's home, 9% had moved house and 38% had died. The probability of not continuing in the programme after three years monitoring was related to less autonomy, presence of comorbidity, and worse cognitive capacity (p < 0.05). Of the 90 patients (37%) who remained active in May 1999, 41% showed disorders on the Short Portable Mental Status Questionnaire (SPMSQ), with a significant relationship to greater age, less autonomy and the presence of comorbidity. Numerous alterations in analysis (21.6%) and linked illnesses (18.9%) were found in the patients with cognitive deterioration. 42% of the patients active in May 99 had fallen during the monitoring period. 10% of the falls involved fractures. The number of falls was higher when there was visual-auditory loss, consumption of psychiatric drugs or absence of use of orthopaedic aids. There was also a greater probability of falls in patients who only had a part-time carer (p < 0.05). It is important to assess the autonomy, cognitive capacity and comorbidity of home-bound chronic patients when monitoring them. Likewise, cognitive disorders and falls must be properly weighed, as they are common in this class of patient.

La calidad del sueño asociada a la polimedicación

Study of the association between multiple medication and the quality of sleep. Observational, cross-sectional study through two-stage sampling of 1053 people with a questionnaire and application of the Pittsburgh Sleep Quality Interview (PSQI). Primary care. Population covered by health centres in the province of Valladolid. Adults over 18 who attended health centres in Valladolid province. As consumption of multiple drugs rose, there was significant deterioration in the overall quality of sleep and each of the following components: subjective quality, latency of sleep, duration of sleep, extrinsic disturbances and consumption of sleeping draughts. No differences were found for day-time repercussions. When psychiatric drug consumption was excluded from the study (to avoid the risk of bias in psychiatric illnesses), deterioration in the quality of sleep, on adding up the remaining therapeutic groups of drugs, was still found. The fact of consuming multiple drugs chronically may condition a deterioration in sleep quality, which will stimulate us to combat this symptom with more drugs and so further aggravate the problem. New prospective studies need to be undertaken to find out the reasons.