Are men under-treated and women over-treated with antidepressants? Findings from a cross-sectional survey in Sweden

Sundbom, Lena Thunander; Bingefors, Kerstin; Hedborg, Kerstin; Isacson, Dag

doi:10.1192/pb.bp.116.054270

Cited by 49 publications

(44 citation statements)

References 50 publications

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“…Although off-label use and overuse are not exactly the same, this agreement is remarkable given the differences in study designs and types of data used [12,13]. Boehlen et al reported a higher proportion of overuse among males which is similar to the pattern observed in our study for off-label use Boehlen, Freigofas, et al 13 , while a survey from Sweden suggested a higher proportion of overtreatment among older women compared to older men [31].…”

Section: Comparison With Other Studiessupporting

confidence: 83%

How often are antidepressants prescribed off‐label among older adults in Germany? A claims data analysis

Schäfer

Reinders

Riedel

et al. 2020

Brit J Clinical Pharma

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Section: Comparison With Other Studiessupporting

confidence: 83%

How often are antidepressants prescribed off‐label among older adults in Germany? A claims data analysis

Schäfer

Reinders

Riedel

et al. 2020

Brit J Clinical Pharma

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“…Both these observations overlap those reported in the epidemiological literature. 22,61,62 Most respondents were affected by schizophrenic and psychotic spectrum disorders (34%), had suffered from mental disorders for a long time (40% of our respondents For personal use only.…”

Section: Discussionmentioning

confidence: 97%

<p>Attitude Towards Drug Therapy in a Community Mental Health Center Evaluated by the Drug Attitude Inventory</p>

Lorenzo¹,

Perrone²,

Montorsi³

et al. 2020

PPA

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Introduction: Negative attitude towards drug therapy can foster limited adherence to treatment, which remains one of the biggest obstacles for implementing effective treatments, especially long term. Purposes: The purposes of the study were 1) to evaluate the attitude towards drug therapy among a representative sample of patients treated in a community psychiatric service using 30-item Drug Attitude Inventory (DAI-30); 2) to evaluate the DAI-30 dimensions, applying factorial analysis; and 3) to highlight the socio-demographic and clinical variables correlated to DAI-30 score and factors. Methods: The DAI was administered, over a 7-month period, to all patients treated in our psychiatric outpatient services who agreed to participate in this study and provided their informed consent. Data were statistically analyzed. Results: With a response rate of 63.3%, 164 females and 136 males completed the DAI-30 with an average score of 14.24 (±10.46 SD), indicating moderately positive attitude towards drug therapy. The analysis of DAI-30 internal consistency confirmed its reliability (Cronbach's alpha=0.84). Our factorial analysis highlighted three factors: Factor 1 (Cronbach's alpha=0.81), composed of 7 items which indicate positive, trustful attitude; Factor 2 (Cronbach's alpha=0.78), composed of 5 items indicating negative attitude of suspiciousness; and Factor 3 (Cronbach's alpha=0.66), composed of 4 items suggesting defensive and control attitude towards drug therapy. Discussion: Among the selected variables, "monotherapy" and "total number of hospitalizations" were negatively correlated to the final score of DAI-30, whereas being "married" was positively correlated to it, in a statistically significant way, using the multiple linear regression model. These correlations suggest that positive attitude towards drug therapy could be reinforced by the condition of being married and reduced by relapses with hospitalization, as literature highlighted, and, paradoxically, by a monotherapy, which could suggest a sort of psychological dependence on therapy and, indirectly, on psychiatric service, potentially correlated to the long-term treatments of our patients.

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“…A male–female proportion at 3:5 was reported in a recent study as the incidence rate of pharmacologically treated depression among individuals 15–44 years of age in Denmark [ 32 ]. This could be a sign of selection bias if men are more often treated with antidepressants compared to women; yet, a Swedish survey study on gender differences in self-reported depression and prescribed antidepressants finds men to report depression to a greater extent than women but prescribed antidepressants to a lesser extent; whereas, women are prescribed antidepressants without reporting depression [ 33 ]. Similarly, a Danish study reports men to have lower use of antidepressants compared to women, when in poor mental health [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic position and mental health care use before and after first redeemed antidepressant and time until subsequent contact to psychologist or psychiatrists: a nationwide Danish follow-up study

Packness

Wehberg

Hastrup

et al. 2020

Soc Psychiatry Psychiatr Epidemiol

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Purpose The purpose was to investigate inequalities in access to care among people with possible depression. Method In this nationwide register-based cohort study of 30,593 persons, we observed the association between socioeconomic position (SEP, education/income) and mental health care use (MHCU) four months before the date of first redeemed antidepressant (Index Date/ID) and 12 months afterwards—and time to contact to psychologist/psychiatrist (PP). Logistic, Poisson, and Cox regression models were used, adjusted for sex, age, cohabitation, and psychiatric comorbidity. Results Before ID, high SEP was associated with less GP contact (general practitioner), higher odds ratios for GP-Mental Health Counseling (GP-MHC), psychologist contact, and admissions to hospital. This disparity decreased the following 12 months for GP-MHC but increased for contact to psychologist; same pattern was seen for rate of visits. However, the low-income group had more contact to private psychiatrist. For the 25,217 individuals with no MHCU before ID, higher educational level was associated with almost twice the rate of contact to PP the following 12 months; for the high-income group, the rate was 40% higher. 10% had contact to PP within 40 days after ID in the group with higher education; whereas, 10% of those with a short education would reach PP by day 120. High-income group had faster access as well. Conclusion Being in high SEP was positively associated with MHCU, before and after ID, and more rapid PP contact, most explicit when measured by education. Co-payment for psychologist may divert care towards private psychiatrist for low-income groups.

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Are men under-treated and women over-treated with antidepressants? Findings from a cross-sectional survey in Sweden

Cited by 49 publications

References 50 publications

How often are antidepressants prescribed off‐label among older adults in Germany? A claims data analysis

How often are antidepressants prescribed off‐label among older adults in Germany? A claims data analysis

<p>Attitude Towards Drug Therapy in a Community Mental Health Center Evaluated by the Drug Attitude Inventory</p>

Socioeconomic position and mental health care use before and after first redeemed antidepressant and time until subsequent contact to psychologist or psychiatrists: a nationwide Danish follow-up study

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