Psychotropic Drug Consumption and Employment Status in Time of Economic Crisis (2007-2011)

Psychotropic medicine use without current or prior medical advice, storage at home and association with perceived stress in a primary health care setting in Greece

OBJECTIVE

Psychotropic medicines use alters according to socio-economic factors and perceived stress. The study aimed to assess the prevalence of use of psychotropic medicines and supplements (PMS) without medical advice, including storage at home, and its relationship with socio-demographic characteristics and perceived stress in primary care patients.

MATERIALS AND METHODS

A cross-sectional sample of adult attendees in an urban primary care unit in Crete, Greece, were surveyed during regularly scheduled appointments during a three-week period in October 2020. A questionnaire was distributed to investigate PMS use during the last 12 months. The validated Greek version of Perceived Stress Scale (PSS-14) was adopted to measure perceived stress.

RESULTS

Of 263 respondents (mean age 46.3±14.5 years; 66.5% females), 101 (38.4%; 95%CI 33.1-43.7%) recalled having psychotropic medicines stored at home cabinets and 72 (27.4%; 95%CI 22.4-32.3%) reported using PMS without medical advice in the last 12 months.

CONCLUSIONS

This study revealed a high prevalence of PMS use without medical advice, including storage at home. People>59 years of age, experiencing irregular sleep and scoring high in PSS, displayed increased prevalence of storing PMS at home or using them without medical advice. The findings could potentially inform primary care providers to focus on patients most likely to be users of PMS without medical advice.

Mid-term psychiatric consequences of the COVID-19 pandemic: a 4 months observational study on emergency room admissions for psychiatric evaluation after the (first) lockdown period in Italy

PURPOSE

The aim of our study is to evaluate the number and the features of admissions to the emergency room (ER) requiring psychiatric consultation, in the period between May 4th and August 31st 2020.

METHODS

We carried out a retrospective longitudinal observational study examining the 4 months following the initial lockdown imposed during the COVID-19 outbreak (May 4th and August 31st 2020). More specifically, the ER admissions leading to psychiatric referral were reviewed at all seven public hospitals of AUSL Romagna (Emilia Romagna region, Italy). Socio-demographic variables, history of medical comorbidities or psychiatric disorders, reason for ER admission, psychiatric diagnosis at discharge, and actions taken by the psychiatrist were collected.

RESULTS

An 11.3% (p = 0.007) increase in psychiatric assessments was observed when compared with the same period of the previous year (2019). A positive personal history of psychiatric disorders (OR:0.68, CI: 0.53-0.87) and assessments leading to no indication for follow-up (OR: 0.22, CI: 0.13-0.39) were significantly less frequent, while there was a significant increase of cases featuring organic comorbidities (OR: 1.24, CI: 1.00-1.52) and suicidal ideation/self-harm/suicide attempt (OR: 1,71, CI: 1.19-2.45) or psychomotor agitation (OR: 1.46, CI: 1.02-2.07) as reason for admission.

CONCLUSIONS

Our results showed an increase in ER psychiatric consultations compared to the previous year, underlying the increased psychological distress caused by the lockdown.

Effects after the lockdown on emergency room admissions for psychiatric evaluation: An observational study from the province of Forlì-Cesena, Italy

The aim was to study the number of accesses to the Emergency Room (ER) requiring psychiatric evaluation in the four months following the lockdown period for the COVID-19 outbreak (May 4th, 2020-August 31th, 2020). The study is a retrospective longitudinal observational study of the ER admissions of the Hospitals of Cesena and Forlì (Emilia Romagna region) leading to psychiatric assessment. Sociodemographic variables, history for medical comorbidities or psychiatric disorders, reason for ER admission, psychiatric diagnosis at discharge and measures taken by the psychiatrist were collected. An increase of 9.4% of psychiatric assessments was observed. The difference was more pronounced in the first two months after lockdown, with a 21.7% increase of number of ER accesses, while after two months numbers were the same as those of the year before. Admission with anxiety symptoms and history of psychiatric disorder decreased significantly. Moreover, there is an age trend with an increasing age of admission.

How did the use of psychotropic drugs change during the Great Recession in Portugal? A follow-up to the National Mental Health Survey

BACKGROUND

Research suggests that economic recessions might be associated with a higher use of psychotropic drugs, but literature is scarce and contradictory in identifying the most vulnerable groups. This study aims to assess possible changes in the use of psychotropic drugs due to the economic recession in Portugal, by comparing self-reported consumption in 2008/09 and 2015/16.

METHODS

Data from the World Mental Health Survey Initiative Portugal (2008/09) and the National Mental Health Survey Follow-Up (2015/16) were used (n = 911). McNemar's tests were performed to estimate changes in consumption of any psychotropic drug and of antidepressants, anxiolytics, and hypnotics/sedatives. Multiple Generalised Estimating Equations models with interaction effects were used to estimate the population odds of consuming psychotropic drugs according to year, gender and age.

RESULTS

An increase of 6.74% was estimated in the consumption of psychotropic drugs from 2008/09 to 2015/16. Population odds of consuming any psychotropic drugs in 2015/16 were estimated to be 1.5 times higher than in 2008/09 (OR = 1.50;95%CI:1.13-2.01), particularly for hypnotics/sedatives (OR = 1.60;95%CI:1.14-2.25). Women and older individuals presented higher odds of consuming any psychotropic drugs (OR = 2.79;95%CI:2.03-3.84, and OR = 1.80;95%CI:1.28-2.54), after adjusting for year of assessment and education. However, when evaluating the interaction effect of the year with gender and age, men and younger individuals reported higher odds of consuming any psychotropic drugs in 2015/16, when compared to 2008/09 (OR = 1.85;95%CI:1.08-3.17, and OR = 1.95;95%CI:1.32-2.90, respectively).

CONCLUSIONS

The findings indicate that the period of economic recession was associated with an increased risk of psychotropic drugs use in Portugal. Consumption of psychotropic drugs remained higher among women and older individuals, but the results suggest that the economic crisis had a disproportionate impact on men and younger individuals. This identification of the most vulnerable population groups is useful to design effective and targeted public health interventions aimed at alleviating the effects of economic recessions.

Efeitos da crise económica e das políticas de austeridade na saúde e no acesso aos cuidados de saúde da população migrante em países do sul da Europa: revisão scoping

Resumo O objectivo deste artigo é reunir e sintetizar o conhecimento existente sobre o impacto da crise económica e das consequentes políticas de austeridade no estado de saúde e no acesso aos cuidados de saúde das populações migrantes em países do sul da Europa, nomeadamente Portugal, Espanha, Itália e Grécia. Os resultados analisados indicam que a crise económica e as políticas de austeridade tiveram um impacto negativo na saúde e no acesso aos cuidados de saúde dos migrantes em três países, já que não se encontraram dados relativos a Portugal. Os seus efeitos negativos espelham-se na saúde mental, saúde ocupacional, doenças transmissíveis e não transmissíveis, saúde infantil e na perceção subjetiva de saúde. A acessibilidade dos cuidados de saúde tornou-se mais limitada em Espanha, especialmente para a população de imigrantes em situação irregular.

Depression in Sardinian immigrants in Argentina and residents in Sardinia at the time of the Argentinian default (2001) and the Great Recession in Italy (2015)

BACKGROUND

The aim of this study is to measure in two samples of Sardinian immigrants in Buenos Aires and representatives of the population in Sardinia the prevalence of depressive symptoms at the time of an economic crisis in Sardinia and to compare these results with those collected at the time of a similar crisis in Argentina more than 10 years before.

METHODS

Observational study. The associations of Sardinian immigrants in Buenos Aires provided the lists of families of Sardinian origin. A random sample of one fifth of registered families was selected. The sample of a study carried out in Sardinia was used as the control. The results were compared with those of the previous study performed in 2001-2002. The Patient Health Questionnaire (PHQ9) was used for the screening of depression.

RESULTS

The Sardinian immigrants show a lower rate of scoring positively on PHQ9 (i.e. less risk of being depressed) and reach statistical significance after standardization (8.7% vs. 13.1%, P = 0.046). Young women (≤40) are at higher risk. On the contrary, the risk of depression was higher in Sardinian immigrants in Argentina during the 2001-2002 crises.

CONCLUSION

The study indicates a risk for depressive episodes linked to the fallout of the economic crisis (in Argentina in 2001-2002, in Sardinia in 2015) and specifically more in females than in males. Due to the associated socio-demographic risk factors, these results could be interpreted as due to an increase in non-bipolar depression.