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Antidepressant use in 27 European countries: Associations with sociodemographic, cultural and economic factors

  • Dan Lewer (a1), Claire O'Reilly (a2), Ramin Mojtabai (a3) and Sara Evans-Lacko (a4)
Abstract
Background

Prescribing of antidepressants varies widely between European countries despite no evidence of difference in the prevalence of affective disorders.

Aims

To investigate associations between the use of antidepressants, country-level spending on healthcare and country-level attitudes towards mental health problems.

Method

We used Eurobarometer 2010, a large general population survey from 27 European countries, to measure antidepressant use and regularity of use. We then analysed the associations with country-level spending on healthcare and country-level attitudes towards mental health problems.

Results

Higher country spending on healthcare was strongly associated with regular use of antidepressants. Beliefs that mentally ill people are ‘dangerous' were associated with higher use, and beliefs that they ‘never recover’ or ‘have themselves to blame’ were associated with lower and less regular use of antidepressants.

Conclusions

Contextual factors, such as healthcare spending and public attitudes towards mental illness, may partly explain variations in antidepressant use and regular use of these medications.

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Copyright
Corresponding author
Sara Evans-Lacko, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK. Email: sara.evans-lacko@kcl.ac.uk
Footnotes
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These authors contributed equally to the work.

Declaration of interest

S.E.L. received consulting fees from Lundbeck.

Footnotes
References
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1 Gusmão, R, Quintão, S, McDaid, D, Arensman, E, Van Audenhove, C, Coffey, C, et al. Antidepressant utilization and suicide in Europe: an ecological multi-national study. PLoS One 2013; 8: e66455.
2 OECD. Health at a Glance: Europe 2012. OECD Publishing, 2012.
3 McManus, S, Meltzer, H, Brugha, T, Bebbington, P, Jenkins, R (eds). Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. NHS Information Centre for Health and Social Care, 2009.
4 Wittchen, HU, Jacobi, F. Size and burden of mental disorders in Europe – a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 2005; 15: 357–76.
5 Wittchen, HU, Jacobi, F, Rehm, J, Gustavsson, A, Svensson, M, Jönsson, B, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 2011; 21: 655–79.
6 Evans-Lacko, S, Brohan, E, Mojtabai, R, Thornicroft, G. Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychol Med 2012; 42: 1741–52.
7 Mojtabai, R. Mental illness stigma and willingness to seek mental health care in the European Union. Soc Psychiatry Psychiatr Epidemiol 2010; 45: 705–12.
8 Anderson, IM, Ferrier, IN, Baldwin, RC, Cowen, PJ, Howard, L, Lewis, G, et al. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2000 British Association for Psychopharmacology guidelines. J Psychopharmacol (Oxf) 2008; 22: 343–96.
9 Lingam, R, Scott, J. Treatment non-adherence in affective disorders. Acta Psychiatr Scand 2002; 105: 164–72.
10 European Commission. Mental Health. Part 1: Report (Special Eurobarometer 345/Wave 73.2). European Commission, 2010.
11 European Commission. Mental Well-being (Special Eurobarometer 248/Wave 64.4). European Commission, 2006.
12 McCabe, CJ, Thomas, KJ, Brazier, JE, Coleman, P. Measuring the mental health status of a population: a comparison of the GHQ-12 and the SF-36 (MHI-5). Br J Psychiatry 1996; 169: 516–21.
13 Ware, JE Jr, Gandek, B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) project. J Clin Epidemiol 1998; 51: 903–12.
14 Kelly, MJ, Dunstan, FD, Lloyd, K, Fone, DL. Evaluating cutpoints for the MHI-5 and MCS using the GHQ-12: a comparison of five different methods. BMC Psychiatry 2008; 8: 10.
15 The World Bank. World Development Indicators 2012. World Bank, 2012.
16 Alonso, J, Angermeyer, MC, Bernert, S, Bruffaerts, R, Brugha, TS, Bryson, H, et al. Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl 2004; 109 (suppl 420): 5564.
17 Ohayon, MM, Lader, MH. The use of psychotropic medication in the general population of France, Germany, Italy, and the United Kingdom. J Clin Psychiatry 2002; 63: 817–25.
18 Mojtabai, R, Olfson, M. National trends in long-term use of antidepressant medications: results from the U.S. National Health and Nutrition Examination Survey. J Clinical Psychiatry 2014; 75: 169–77.
19 Pratt, LA, Brody, DJ, Gu, Q. Antidepressant Use in Persons Aged 12 and over: United States, 2005–2008 (NCHS Data Brief No. 76). U.S. Department of Health and Human Services, 2011.
20 Stagnitti, MN. Antidepressant Use in the U.S. Civilian Noninstitutionalized Population, 2002. Medical Expenditure Panel Survey, Agency for Healthcare Research and Quality, 2005.
21 Dunn, RL, Donoghue, JM, Ozminkowski, RJ, Stephenson, D, Hylan, TR. Longitudinal patterns of antidepressant prescribing in primary care in the UK: comparison with treatment guidelines. J Psychopharmacol (Oxf) 1999; 13: 136–43.
22 Pound, P, Britten, N, Morgan, M, Yardley, L, Pope, C, Daker-White, G, et al. Resisting medicines: a synthesis of qualitative studies of medicine taking. Soc Sci Med 2005; 61: 133–55.
23 Hynd, A, Roughead, EE, Preen, DB, Glover, J, Bulsara, M, Semmens, J. The impact of co-payment increases on dispensings of government-subsidised medicines in Australia. Pharmacoepidemiol Drug Saf 2008; 17: 1091–9.
24 Corrigan, P, Markowitz, FE, Watson, A, Rowan, D, Kubiak, MA. An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav 2003; 44: 162–79.
25 Mossakowski, KN, Kaplan, LM, Hill, TD. Americans' attitudes toward mental illness and involuntary psychiatric medication. Soc Ment Health 2011; 1: 200–16.
26 Kvaale, EP, Gottdiener, WH, Haslam, N. Biogenetic explanations and stigma: a meta-analytic review of associations among laypeople. Soc Sci Med 2013; 96: 95103.
27 Pescosolido, BA, Martin, JK, Long, JS, Medina, TR, Phelan, JC, Link, BG. “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiatry 2010; 167: 1321–30.
28 Rüsch, N, Todd, AR, Bodenhausen, GV, Corrigan, PW. Biogenetic models of psychopathology, implicit guilt, and mental illness stigma. Psychiatry Res 2010; 179: 328–32.
29 Schomerus, G, Schwahn, C, Holzinger, A, Corrigan, PW, Grabe, HJ, Carta, MG, et al. Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatr Scand 2012; 125: 440–52.
30 Evans-Lacko, S, Knapp, M, McCrone, P, Thornicroft, G, Mojtabai, R. The mental health consequences of the recession: economic hardship and employment of people with mental health problems in 27 European countries. PLoS One 2013; 8: e69792.
31 Cotterchio, M, Kreiger, N, Darlington, G, Steingart, A. Comparison of self-reported and physician-reported antidepressant medication use. Ann Epidemiol 1999; 9: 283–9.
32 Kwon, A, Bungay, KM, Pei, Y, Rogers, WH, Wilson, IB, Zhou, Q, et al. Antidepressant use: concordance between self-report and claims records. Med Care 2003; 41: 368–74.
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Antidepressant use in 27 European countries: Associations with sociodemographic, cultural and economic factors

  • Dan Lewer (a1), Claire O'Reilly (a2), Ramin Mojtabai (a3) and Sara Evans-Lacko (a4)
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