Género y psicofármacos: la opinión de los prescriptores a través de una investigación cualitativa

Abstract

Structural sample. Interviews conducted by the research team. Strategy of analysis in two distinct processes: contents analysis with agreed categories and gender analysis of the discourse. RESULTS. The prescribers found that taking psychiatric medication was associated with sex, age, social and economic category, and social expectations. In the discourses we found consumer profiles emerging that were not found in the epidemiological literature. Discourse analysis showed implicit gender bias in the beliefs of some prescribers. CONCLUSIONS. To minimise the growing offer and demand for psychiatric medication, prescribers thought training in diagnosis and psychotherapy should be improved, case-loads should be reduced, co-ordination between services improved and alternative treatments favoured. To minimise gender bias in the diagnosis and prescription of psychiatric medication, we think training is needed on the influence of cultural and gender factors on the process of construction of identities.

Psychotropic use patterns: Are there differences between men and women?

“…Beliefs regarding the greater frailty of the female sex lead to an unequal evaluation of the same health problems. Thus, physicians tend to diagnose emotional/mental problems more in women and prescribe them anxiolytic agents and antidepressants more [ 27 , 28 ].…”

“…Men often have greater difficulty expressing emotions, such as anxiety and depression, due to a fear of being perceived as vulnerable and/or frail [ 51 ] and therefore seeking mental health care depends on the severity of the problem in males [ 26 ]. This situation is also reflected in the attitudes of prescribing physicians, who often consider the complaints of men to be more serious in comparison to those of women [ 28 ]. Furthermore, contemporary society believes that medications have become indispensible to the normalization of the lives of individuals, as these substances enable the return to routine activities of daily living.…”

Berdin artatzen al ditugu pazienteak emakumezko ala gizonezko izan?

“…Osasun (38). Psikofarmakoen preskripzioaren inguruan egindako ikerketa kualitatibo baten arabera, osasun-arazo berberen aurrean, emakumezkoen ahultasunaren inguruko sinesmen ideologikoak balorazio ezberdina eginarazten zien hainbat autonomia-erkidegotako medikuei, Euskadi tarteko (39).…”

Una propuesta para abordar la doble ceguera: la Terapia Familiar Crítica sensible al Género.

“…Por otra parte, en el ámbito de los diagnósticos, existen diferencias notables entre hombres y mujeres en relación a la frecuencia y motivos de consulta, diagnósticos y tratamientos asignados en el campo de la salud mental. En primer lugar, las mujeres son más propensas a buscar ayuda por problemas de salud mental (Mackenzie, Gekoski, y Knox, 2006;Oliver, Pearson, Coe, y Gunnell, 2005) y se les prescriben, en igualdad de condiciones, más psicofármacos (García et al, 2005;Markez et al, 2004). En segundo lugar, existen diferencias epidemiológicas en los trastornos mentales por género: a las mujeres se les diagnostica con más frecuencia de trastornos de ansiedad, de personalidad límite, de la conducta alimentaria y trastornos de dolor, así como de trastornos afectivos, principalmente depresión, incluso aunque tengan resultados similares en pruebas estandarizadas o síntomas idénticos a los varones (Astbury, 2001); mientras que a los varones, de trastornos de personalidad antisocial y narcisista, trastorno delirante celotípico, del control de los impulsos, así como abuso y dependencia de sustancias (Barberá y Martínez, 2004;Bonilla, 2010aBonilla, , 2010bFerrer y Bosch, 2005;Grela y López, 2011;Montero et al, 2004;Organización Mundial de la Salud, 2004;Ruiz y Jiménez, 2003;Sebastián, 2001).…”