Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-25T07:06:44.907Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychotropic drug use in Northern Ireland 1966–80: prescribing trends, inter- and intra-regional comparisons and relationship to demographic and socioeconomic variables

Published online by Cambridge University Press:  09 July 2009

David J. King ,
Kathryn Griffiths ,
Phillip M. Reilly  and
J. Desmond Merrett
David J. King*
Affiliation:
Department of Therapeutics and Pharmacology, The Queen's University of Belfast
Kathryn Griffiths
Affiliation:
Department of Therapeutics and Pharmacology, The Queen's University of Belfast
Phillip M. Reilly
Affiliation:
Department of Therapeutics and Pharmacology, The Queen's University of Belfast
J. Desmond Merrett
Affiliation:
Department of Therapeutics and Pharmacology, The Queen's University of Belfast
*
1Address for correspondence: Dr D. J. King, Department of Therapeutics and Pharmacology, Whitla Medical Building, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland
Get access Rights & Permissions [Opens in a new window]

Synopsis

A study of psychotropic drug prescribing, derived from the computerized pricing data in Northern Ireland from 1966, showed that the use of these drugs reached a peak in 1975, when about 12·5% of the adult population were estimated to have been receiving them, and declined in the following 5 years. Benzodioazepines accounted for three-quarters of all psychotropic drugs prescribed in 1980. Benzodiazepine tranquillizer prescribing was consistently 20–30% higher than in the rest of the United Kindom, in contrast to hypnotic and antidepressant prescribing which has been consistently lower. The rate of increase in benzodiazepine tranquillizer prescribing was greater than in other European countries, but the level remains lower than in Iceland and Denmark. The influence of a number of demographic and socioeconomic variables was studied in an intra-regional analysis of the 1978 data for the 17 health districts in the province, using multivariate and multiple regression statistics. The prescribing of benzodiazepine hypnotics was almost entirely accounted for by the proportion of elderly (over 65 years) and women aged 45–59 years; neuroleptic prescribing was largely a function of factors associated with rural areas (overcrowding and unemployment) and the proportion of elderly; but neither tranquillizer, antidepressant, barbiturate hypnotic nor psychostimulant prescribing were satisfactorily explained by these variables.

Type
Research Article
Information
Psychological Medicine , Volume 12 , Issue 4 , November 1982 , pp. 819 - 833
Copyright
Copyright © Cambridge University Press 1982

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

Anderson, R. (1980). Prescribed medicines: who takes what? Journal of Epidemiology and Community Health 34, 299–304.CrossRefGoogle Scholar
Balter, M. B., Levine, J. & Manheimer, D. I. (1974). Cross-national study of the extent of anti-anxiety/sedative drug use. New England Journal of Medicine 290, 769–774.CrossRefGoogle ScholarPubMed
Blaney, R. & Mackenzie, G. (1980). The prevalence of problem drinking in Northern Ireland: a population study. International Journal of Epidemiology 9, 159–166.CrossRefGoogle ScholarPubMed
Böethius, G. & Westerholm, B. (1977). Purchases of hypnotics, sedatives and minor tranquillizers among 2566 individuals in the county of Jamtland, Sweden – a 6 years'follow up. Acta psychiatrica scandinavica 56, 147–159.Google Scholar
Clare, A. W. (1971). Diazepam, alcohol and barbiturate abuse. British Medical Journal iv, 340.CrossRefGoogle Scholar
Committee on the Review of Medicines (1980). Systematic review of benzodiazepines. British Medical Journal 280, 910–912.Google Scholar
Dean, G., Downing, H. & Shelley, E. (1981). First admissions to psychiatric hospitals in south-east England in 1976 among immigrants from Ireland. British Medical Journal 282, 1831–1833.CrossRefGoogle ScholarPubMed
Dennis, P. J. (1979). Monitoring of psychotropic drug prescribing in general practice. British Medical Journal ii. 1115–1116.CrossRefGoogle Scholar
Dunnell, K. & Cartwright, A. (1972). Medicine Takers, Prescribers and Hoarders, pp. 75–77. Routledge and Kegan Paul: London.Google Scholar
Elmes, P. C., Hood, H., McMeekin, C. & Wade, O. L. (1976 a). Prescribing in Northern Ireland: study number 1, sleeping tablets. Ulster Medical Journal 45, 166–177.Google Scholar
Elmes, P. C., Hood, H. & Wade, O. L. (1976 b). Prescribing in Northern Ireland: methods of analysis. Ulster Medical Journal 45, 56–58.Google ScholarPubMed
Factor, R. M. & Waldron, I. (1973). Contemporary population densities and human health. Nature 243, 381–384.CrossRefGoogle ScholarPubMed
Faris, R. E. L. & Dunham, H. W. (1939). Mental Disorders in Urban Areas. University of Chicago Press: Chicago.Google Scholar
Fraser, R. M. (1971). The cost of commotion: an analysis of the psychiatric sequelae of the 1969 Belfast riots. British Journal of Psychiatry 118, 257–264.CrossRefGoogle ScholarPubMed
Galle, O. R., Gove, W. R. & McPherson, J. M. (1972). Population density and pathology: What are the relations for man? Science 176, 23–30.CrossRefGoogle ScholarPubMed
Grímsson, A. & Ólafsson, Ó. (1981). Drug prescriptions in Reykjavik according to age, sex and marital status. In Drugs in Iceland (ed. Ólafsson, Ó.), pp. 65–74. Landlaeknisembaettid: Reykjavik.Google Scholar
Grímsson, A., Idänpään-Heikkilä, J., Lunde, P. K. M., Ólafsson, Ó. & Westerholm, B. (1979). The utilization of psychotropic drugs in Finland, Iceland. Norway and Sweden. In Studies in Drug Utilization: Methods and Applications (ed. Bergman, U., Grímsson, A., Wahba, A. H. W. and Westerholm, B.), pp. 163–167. WHO Regional Publications European Series No 8. WHO Regional Office for Europe: Copenhagen.Google Scholar
Helgason, T. (1964). Epidemiology of mental disorders in Iceland. Acta psychiatrica scandinavica, Suppl. 173, pp. 165–166. Munksgaard: Copenhagen.Google Scholar
Holding, T. A., Buglass, D., Duffy, J. C. & Kreitman, N. (1977). Parasuicide in Edinburgh a seven year review 1968 74. British Journal of Psychiatry 130, 534–543.CrossRefGoogle Scholar
Hollingshead, A. B. & Redlich, F. C. (1958). Social Class and Mental Illness: A Community Study, p. 210. Wiley: New York.CrossRefGoogle Scholar
Howe, J. G. (1980). Lorazepam withdrawal seizures. British Medical Journal 280, 1163–1164.CrossRefGoogle ScholarPubMed
Howie, J. G. R. & Bigg, A. R. (1980). Family trends in psychotropic and antibiotic prescribing in general practice. British Medical Journal 280. 836–838.CrossRefGoogle ScholarPubMed
Idänpään-Heikkilä, J. (1977). Use of anxiolytics, sedatives, hypnotics. antidepressants and neuroleptics in Finland in 1966–1976. Suomen Apteekkarilehti 1, 20–31.Google Scholar
Idänpään-Heikkilä, J. (1979). Data collection in Finland. In Studies in Drug Utilization: Methods and Applications (ed. Bergman, U., Grímsson, A., Wahba, A. H. W. and Westerholm, B.), pp. 35–48. WHO Regional Publications European Series No. 8. WHO Regional Office for Europe: Copenhagen.Google Scholar
Joyce, C. R. B., Last, J. M. & Weatherall, M. (1968). Personal factors as a cause of differences in prescribing by general practitioners. British Journal of Preventive and Social Medicine 22. 170–177.Google ScholarPubMed
King, D. J., McMeekin, C. & Elmes, P. C. (1977). Are we as depressed as we think we are? Ulster Medical Journal 46, 105–112.Google ScholarPubMed
King, D. J., Griffiths, K., Hall, C. E., Cooper, N. C. & Morrison, D. J. (1980). Effect of the CURB campaign on barbiturate prescribing in Northern Ireland. Journal of the Royal College of General Practitioners 30, 614–618.Google ScholarPubMed
Langner, T. S. & Michael, S. T. (1963). Life Stress and Mental Health. The Midtown Manhattan Study. Thomas A. C. Rennie Series in Social Psychiatry vol. 2. Collier-Macmillan: London.Google Scholar
Lunde, P. K. M., Baksaas, I., Halse, M., Halvorsen, I. K., Strømnes, B. & Øydvin, K. (1979). The methodology of drug utilization studies. In Studies in Drug Utilization: Methods and Applications (ed. Bergman, U., Grímsson, A., Wahba, A. H. W. and Westerholm, B.), pp. 17–28. WHO Regional Publications European Series No. 8. WHO Regional Office for Europe: Copenhagen.Google Scholar
Lyons, H. A. (1971). Psychiatric sequelae of the Belfast riots. British Journal of Psychiatry 118, 265–273.CrossRefGoogle ScholarPubMed
Lyons, H. A. (1972). Depressive illness and aggression in Belfast. British Medical Journal i, 342–345.CrossRefGoogle Scholar
Lyons, H. A. (1977). Psychological sequelae of the terrorist bombing. The Police Surgeon 12, 52–59.Google Scholar
Maletzky, B. M. & Klotter, J. (1976). Addiction to diazepam. The International Journal of Addictions 11 (1), 95–115.CrossRefGoogle ScholarPubMed
McDevitt, D. G. & McMeekin, C. (1979). Data collection in Northern Ireland. In Studies in Drug Utilization: Methods and Applications (ed. Bergman, U., Grímsson, A., Wahba, A. H. W. and Westerholm, B.), pp. 103–111. WHO Regional Publications European Series No. 8. WHO Regional Office for Europe: Copenhagen.Google Scholar
Moore, B. G., Geddes, G. L. & Patterson, A. W. (1981). Prescribed doses of benzodiazepines. Unit for Research into Drug Usage. Heriot-Watt University, Edinburgh.Poster presentation at WHO Drug Utilization Research Group Meeting,Korčula,28 30 April.Google Scholar
Murray, D. (1976). Ulster– the tranquillized province? Belfast Telegraph, 15 06.Google Scholar
Nordic Council on Medicines (1979 a). Nordic Statistics on Medicines. 1975–1977, Part I. Helsingfors.Google Scholar
Nordic Council on Medicines (1979 b). The Anatomical Therapeutic Chemical Classification System (ATC) and Defined Daily Doses. Nordic Statistics on Medicines 1975–1977. Part II. Helsingfors.Google Scholar
Ödegaard, O. (1973). Norwegian emigration, re-emigration and internal migration. In Uprooting and After (ed. Zwingmann, C. A. and Pfister-Ammende, M.), pp. 169–174. Springer-Verlag: Berlin.Google Scholar
Ogburn, W. (1964). On Culture and Social Change. Selected papers edited with an introduction by Duncan, O. D.. p. 101. University of Chicago Press: Chicago.Google Scholar
Ólafsson, Ó. (1981). Prescription habits of G.P. in Reykjavik and rural areas of Iceland on hypnotics and psychotropic drugs. In Drugs in Iceland (ed. Ólafsson, Ó.). pp. 33–40. Landlaeknisembaettid: Reykjavik.Google Scholar
Ólafsson, Ó., Sigfússon, S. & Grímsson, A. (1980). Control of addictive drugs in Iceland 1976–1978. Journal of Epidemiology and Community Health 34, 305–308.CrossRefGoogle Scholar
Parkin, D. (1979). Distance as an influence on demand in general practice. Journal of Epidemiology and Community Health 33, 96–99.CrossRefGoogle ScholarPubMed
Petursson, H. & Lader, M. H. (1981 a). Withdrawal reaction from clobazepam. British Medical Journal 282, 1931–1932.CrossRefGoogle Scholar
Petursson, H. & Lader, M. H. (1981 b). Withdrawal from long-term benzodiazepine treatment. British Medical Journal 283, 643–645.CrossRefGoogle ScholarPubMed
Ratna, L. (1981). Addiction to temazepam. British Medical Journal 282, 1837–1838.CrossRefGoogle ScholarPubMed
Registrar General (1973). Annual Statistical Review, England and Wales. Part 1. Tables Medical. HMSO: London.Google Scholar
Rickels, K. (1981). Are benzodiazepines overused and abused? British Journal of Clinical Pharmacology 11, 71S–83S.CrossRefGoogle ScholarPubMed
Royal College of General Practitioners, Office of Population Censuses and Surveys, and Department of Health and Social Security (1979). Morbidity Statistics from General Practice 1971–1972, p. 119. Second National Study. Studies on Medical and Population Subjects No. 36. HMSO: London.Google Scholar
Schweitzer, L. & Su, W-H. (1977). Population density and the rate of mental illness. American Journal of Public Health 67, 1165–1172.CrossRefGoogle ScholarPubMed
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. (1966). Psychiatric Illness in General Practice, pp. 97–105. Oxford University Press: London.Google Scholar
Skegg, D. C. G., Doll, R. & Perry, J. (1977). Use of medicines in general practice. British Medical Journal i, 1561–1563.CrossRefGoogle Scholar
Stolley, P. D., Becker, M. H., Lasagna, L., McEvilla, J. D. & Sloane, L. M. (1972). The relationship between physician characteristics and prescribing appropriateness. Medical Care 10, 17–28.CrossRefGoogle ScholarPubMed
Trethowan, W. H. (1975). Pills for personal problems. British Medical Journal iii, 749–751.CrossRefGoogle Scholar
Tyrer, P. (1978). Drug treatment of psychiatric patients in general practice. British Medical Journal ii, 1008–1010.CrossRefGoogle Scholar
Tyrer, P., Rutherford, D. & Huggett, T. (1981). Benzodiazepine withdrawal symptoms and propranolol. Lancet i, 520–522.CrossRefGoogle Scholar
Walsh, D. (1971). Patients in Irish psychiatric hospitals in 1963– a comparison with England and Wales, British Journal of Psychiatry 118, 617–620.CrossRefGoogle ScholarPubMed
Westerholm, B. (1979). Data collection in Sweden. In Studies in Drug Utilization: Methods and Applications (ed. Bergman, U., Grímsson, A., Wahba, A. H. W. and Westerholm, B.), pp. 73–82. WHO Regional Publications European Series No. 8. WHO Regional Office for Europe: Copenhagen.Google Scholar