Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-22T18:54:46.407Z Has data issue: false hasContentIssue false
  • English
  • Français

Infrequent use of antidepressants in depressed individuals (an interview and prescription database study in a defined Swedish population 2001–2002)

Published online by Cambridge University Press:  16 April 2020

S. Henriksson ,
R. Asplund ,
G. Boëthius ,
T. Hällström  and
G. Isacsson
S. Henriksson*
Affiliation:
Karolinska Institute, Clinical neuroscience, Section psychiatry, Karolinska University Hospital, Huddinge, Sweden
R. Asplund
Affiliation:
Family Medicine, Stockholm, Karolinska Institute, Huddinge University Hospital Sweden and the Research and Development Unit, Jämtland County Council, Östersund, Sweden
G. Boëthius
Affiliation:
Tobacco Control Unit, Östersund Hospital, Östersund, Sweden
T. Hällström
Affiliation:
Karolinska Institute, Clinical neuroscience, Section psychiatry, Karolinska University Hospital, Huddinge, Sweden
G. Isacsson
Affiliation:
Karolinska Institute, Clinical neuroscience, Section psychiatry, Karolinska University Hospital, Huddinge, Sweden
*
*Corresponding author. Psychiatric Center Karolinska, Karolinska Hospital, S-171 76 Stockholm, Sweden. Tel.: +46 8 5177 6758; Mobile: +46 70 305 5456; fax: +46 8 30 3706. E-mail address: [email protected] (S. Henriksson).
Get access

Abstract

Purpose:

To investigate whether antidepressants are over-used, under-used, or misused, by determining to what extent the depressed individuals in a defined population are treated with antidepressant medication and, from the other end, to what extent prescribed antidepressants are aimed for the treatment of depression.

Subjects and method:

From an individual based prescription database in the County of Jämtland, 2048 individuals representative for the general population were selected. The presence of current depression in these individuals was screened by a mailed self-screening questionnaire. Individuals with depression according to the questionnaire were interviewed by a psychiatrist using a structured interview (SCAN) to confirm the diagnosis. Their use of antidepressants was obtained from the prescription database.

Results:

Sixty-two (4.5%) out of 1375 were diagnosed with depression and 17 (27%) of these were taking an antidepressant. In addition 44 individuals, currently not depressed, were taking antidepressants. Twenty-five of these were interviewed per telephone and it was found that the indications for 18 of them were continuation treatment of depression, and for seven of them pain, sleep disturbance or anxiety.

Conclusion:

Antidepressants appear to be under-used in the population. Only one in four of the depressed individuals was treated with antidepressant medication. Those who had antidepressant medication without being currently depressed had, with few exceptions, either continuation treatment for depression in remission or treatment on other approved indications.

Keywords

DepressionPrevalenceAntidepressants
Type
Original article
Information
European Psychiatry , Volume 21 , Issue 6 , September 2006 , pp. 355 - 360
Copyright
Copyright © Elsevier SAS 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angst, J.Epidemiology of depression Psychopharmacology (Berl.) 1992; 106:S71–S74.CrossRefGoogle ScholarPubMed
Airaksinen, E., Larsson, M., Lundberg, I., Forsell, Y.Cognitive functions in depressive disorders: evidence from a population-based study Psychol. Med. 2004; 34:83–91.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4 ed Washington, DC: American Psychiatric Association; 1994.Google Scholar
Andersen, U., Andersen, M., Rosholm, J.L LG. Psychopharmacological treatment and psychiatric morbidity in 390 cases of suicide with special focus on affective disorders Acta Psychiatr. Scand. 2001; 104:458–465.CrossRefGoogle Scholar
Ayuso-Mateos, J., Vázquez-Barquero, J., Dowrick, C., Lehtinen, V., Dalgard, O., Casey, P.et al.Depressive disorders in Europe: prevalence figures from the ODIN study Br. J. Psychiatry 2001; 179:308–316.CrossRefGoogle ScholarPubMed
Bebbington, P., Marsden, L., Brewin, C.The need for psychatric treatment in the general population: Camberwell Needs for Care Survey Psychol. Med. 1997; 27:821–834.CrossRefGoogle Scholar
Bech, P., Wermuth, L.Applicability and validity of the Major Depression Inventory in patients with Parkinson’s disease Nord. J. Psychiatry 1998; 52:305–309.CrossRefGoogle Scholar
Blazer, D.G., Kessler, R.C., McGonagle, K.A., Swartz, M.S.The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey Am. J. Psychiatry 1994; 151:979–986.Google Scholar
Druss, B., Hoff, R., Rosenheck, R.Underuse of antidepressants in major depression: prevalence correlates in a national sample of young adults J. Clin. Psychiatry 2000; 61:234–237.CrossRefGoogle Scholar
Henriksson, S., Boëthius, G., Isacsson, G.Suicides are seldom prescribed antidepressants: findings from a prospective prescription database in Jämtland county, Sweden, 1985-95 Acta Psychiatr. Scand. 2001; 103:301–306.CrossRefGoogle Scholar
Henriksson, S., Boëthius, G., Håkansson, J., Isacsson, G.Indications for and outcome of antidepressant medication in a general population: a prescription database and medical record study, in Jämtland county, Sweden, 1995 Acta Psychiatr. Scand. 2003; 108:427–431.CrossRefGoogle Scholar
Isacsson, G., Rich, C.L.Management of patients who deliberately harm themselves BMJ 2001; 322:213–215.CrossRefGoogle ScholarPubMed
Isacsson, G.Suicide prevention-a medical breakthrough Acta Psychatr Scand 2000; 102:113–117.CrossRefGoogle ScholarPubMed
Isacsson, G., Boëthius, G., Henriksson, S., Jones, J., Bergman, U.SSRIs have broadened the utilisation of antidepressants in accordance with recommendations. Findings from a Swedish prescription database J. Affect. Disord. 1999; 53:15–22.CrossRefGoogle ScholarPubMed
Kessler, R., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K.et al.The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R) JAMA 2003; 289:3095–3105.CrossRefGoogle Scholar
Laukkala, T., Isometsä, E., Hämäläinen, J., Heikkinen, M., Lindeman, S., Aro, H.Antidepressant Treatment of Depression in the Finnish General Population Am. J. Psychiatry 2001; 158:2077–2079.CrossRefGoogle ScholarPubMed
Lepine, J., Gastpar, M., Mendlewicz, J., Tylee, A.Depression in the community: the first pan-European study DEPRES (Depression Research in European Society) Int. Clin. Psychopharmacol. 1997; 12:19–29.CrossRefGoogle Scholar
Norusis, M.J.SPSS 6.1 Base System User’s Guide, Part2 Chicago: SPSS Inc.; 1994.Google Scholar
Ohayon, M., Lader, M.Use of psychotropic medication in the general population of France, Germany, Italy, and the United Kingdom J. Clin. Psychiatry 2002; 63:817–825.CrossRefGoogle ScholarPubMed
Parikh, S., Lesage, A., Kennedy, S., Goering, P.Depression in Ontario: under-treatment and factors related to antidepressant use J. Affect. Disord. 1999; 52:67–76.CrossRefGoogle ScholarPubMed
Pincus, H.A., Tanielian, T.L., Marcus, S.C., Olfson, M., Zarin, D.A., Thompson, J.et al.Prescribing trends in psychotropic medications. Primary care, psychiatry, and other medical specialties JAMA 1998; 279:526–531.CrossRefGoogle ScholarPubMed
Rosholm, J.-U., Gram, L.F., Isacsson, G., Hallas, J., Bergman, U.Changes in the pattern of antidepressant use upon the introduction of the new antidepressants: a prescription database study Eur. J. Clin. Pharmacol. 1997; 52:205–209.CrossRefGoogle ScholarPubMed
Rutz, W., Carlsson, P., von Knorring, L., Wålinder, J.Cost-benefit analysis of an educational program for general practitioners by the Swedish Committee for the Prevention and Treatment of Depression Acta Psychiatr. Scand. 1992; 85:457–464.CrossRefGoogle ScholarPubMed
Rutz, W., von Knorring, L., Wålinder, J., Wistedt, B.Effect of an educational program for general practitioners on Gotland on the pattern of prescription of psychotropic drugs Acta Psychiatr. Scand. 82(6)1990 399–403.CrossRefGoogle ScholarPubMed
Spijker, J., Bijl, R., Graaf, R.D., Nolen, W.Care utilization and outcome of DSM-III-R major depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) Acta Psychiatr. Scand. 2001; 104:19–24.CrossRefGoogle Scholar
Storosum, J., Elferink, A., Zwieten, B.V., Brink, W.V.D., Gersons, B., Strik, R.V.et al.Short-term efficacy of tricyclic antidepressants revisited: a meta-analytic study Eur Neuropsychopharmacol 2001; 11:173–180.CrossRefGoogle ScholarPubMed
Suominen, K., Isometsä, E., Henriksson, M., Ostamo, A., Lonnqvist, J.Inadequate treatment for major depression both before and after attempted suicide Am. J. Psychiatry 1998; 155:1778–1780.CrossRefGoogle ScholarPubMed
Tylee, A., Gastpar, M., Lepine, J., Mendlewicz, J.DEPRES II (Depression Research in European Society II): a patient survey of the symptoms, disability and current management of depression in the community. DEPRES Steering Committee Int. Clin. Psychopharmacol. 1999; 14:139–151.Google ScholarPubMed
WHO. Schedules for clinical assessment in neuropsychiatry, Version 2.1. Manual Geneva: World Health Organization; 1998.Google Scholar
Wing, J., Babor, T., Brugha, T., Burke, J., Cooper, J., Giel, R.et al.SCAN: Schedules for clinical assessment in neuropsychaitry Arch. Gen. Psychiatry 1990; 47:589–593.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.