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Kim ES, Yeo J, Kim Y, Ha IH. The Impact of Moderate Earthquakes on Antidepressant Prescriptions in Ulsan, South Korea: A Controlled Interrupted Time Series Analysis. J Epidemiol 2023; 33:600-606. [PMID: 36372434 PMCID: PMC10635813 DOI: 10.2188/jea.je20220171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/18/2022] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND In 2016, two consecutive moderate magnitude earthquakes occurred in Ulsan, South Korea. Therefore, we aimed to investigate the impact of earthquakes on the mental health of residents in Ulsan. METHODS We used data from the 2015-2017 Korean Health Insurance Review & Assessment Service National Patient Sample. We conducted an interrupted time series analysis using location-based controls. Changes in the number of antidepressants, benzodiazepines, and zolpidem prescriptions in Ulsan were compared to controls. Overall changes in weekly prescriptions 1 year after the first earthquake, compared to a non-earthquake scenario, were estimated. RESULTS In antidepressant prescriptions, the increase in trend after an earthquake was significantly higher than controls. However, the changes in benzodiazepines and zolpidem prescribing were not significant. Overall, the impact of the earthquake on weekly antidepressant prescriptions at 1 year was estimated as a 1.32 (95% CI, 1.18-1.56) rate ratio compared to the non-earthquake scenario. This corresponded to an increase of 1,989.7 (95% CI, 1,202.1-3,063.0) in the number of prescriptions. Among subgroups, the increase was highest among males aged 20-39 years. CONCLUSION The moderate earthquake in Ulsan was associated with an increase in antidepressant prescriptions. The increase in the male group aged 20-39 was the highest. The impact may vary according to the context of the population.
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Affiliation(s)
- Eun-San Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Jiyoon Yeo
- Department of Economics, Korea University, Seoul, Republic of Korea
| | - Yongjoo Kim
- College of Korean Medicine, Sangji University, Wonju, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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2
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Moriwaki Y, Morisaki Y, Karashima S, Fujiu M. Analysis of Pharmaceutical Demand in the Region for Chronic Medicine Users Using National Health Insurance Data: Examination for Disaster Preparedness in Hakui City, Ishikawa Prefecture. Healthcare (Basel) 2023; 11:3029. [PMID: 38063597 PMCID: PMC10871114 DOI: 10.3390/healthcare11233029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/02/2023] [Accepted: 11/16/2023] [Indexed: 02/18/2024] Open
Abstract
When large earthquakes occur over wide areas, in addition to damage to medical facilities, the disaster response capabilities of local governments are severely compromised. There is a very high possibility that the supply-demand balance of medicines will collapse within the disaster area, and that appropriate supplies of medicines will not be provided to disaster victims. Therefore, it is important to estimate in advance the quantity of pharmaceuticals that may be needed during disasters. In this study, the purpose is to clarify the quantity and quality of pharmaceuticals used by chronically ill patients by using Japanese National Health Insurance data regarding the issues mentioned above. The methodology used was to extract the status of pharmaceutical prescriptions based on receipt information from National Health Insurance data for Hakui, Ishikawa Prefecture, a small regional city in Japan, as the analysis target area. Through the analysis in this study, the quantity and quality of medicines supplied to chronically ill patients in Hakui, Ishikawa Prefecture, were clarified on a town-by-town basis.
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Affiliation(s)
- Yuta Moriwaki
- Division of Geosciences and Civil Engineering, Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa 920-1192, Japan;
| | - Yuma Morisaki
- Faculty of Transdisciplinary Sciences for Innovation, Institute of Transdisciplinary Sciences for Innovation, Kanazawa University, Kanazawa 920-1192, Japan;
| | - Shigehiro Karashima
- Institute of Liberal Arts and Science, Kanazawa University, Kanazawa 920-1192, Japan;
| | - Makoto Fujiu
- Faculty of Transdisciplinary Sciences for Innovation, Institute of Transdisciplinary Sciences for Innovation, Kanazawa University, Kanazawa 920-1192, Japan;
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Marconi AM, Myers US, Hanson B, Nolan S, Sarrouf EB. Psychiatric medication prescriptions increasing for college students above and beyond the COVID-19 pandemic. Sci Rep 2023; 13:19063. [PMID: 37925588 PMCID: PMC10625532 DOI: 10.1038/s41598-023-46303-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
Psychiatric medication prescriptions for college students have been rising since 2007, with approximately 17% of college students prescribed medication for a mental health issue. This increase mirrors overall increases in both mental health diagnoses and treatment of university students. As psychiatric medication prescriptions for college students were increasing prior to pandemic, the goal of this study was to compare these prescriptions over the years, while accounting for the added stressor of the COVID-19 pandemic. This study utilized cross-sectional, retrospective data from a cohort of college students receiving care from the university's health service. We examined prescriptions for mental healthcare from 2015 to 2021. There was a significant increase in the percentage of psychiatric medication prescriptions in 2020 (baseline 15.8%; threshold 3.5%) and 2021 (baseline 41.3%; threshold 26.3%) compared to the historical baseline average for the whole sample and as well as for female students (2020 baseline 21.3% and threshold 4.6%; 2021 baseline 55.1% and threshold 33.7%). Within these years, we found higher trends for prescriptions in April-May as well as September-December. Overall, we found that psychiatric medication prescriptions have continued to rise through the years, with a large increase occurring during the pandemic. In addition, we found that these increases reflect the academic year, which is important for university health centers to consider when they are planning to staff clinics and plan the best way to treat college students with mental health difficulties in the future.
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Affiliation(s)
- Agustina M Marconi
- University Health Services, University of Wisconsin Madison, 333 East Campus Mall, Madison, WI, 53715, USA.
| | - Ursula S Myers
- Medical University of South Carolina (MUSC), 171 Ashley Ave, Charleston, South Carolina, 29425, USA
| | - Bjorn Hanson
- University Health Services, University of Wisconsin Madison, 333 East Campus Mall, Madison, WI, 53715, USA
| | - Sarah Nolan
- University Health Services, University of Wisconsin Madison, 333 East Campus Mall, Madison, WI, 53715, USA
| | - Elena Beatriz Sarrouf
- Direction of Epidemiology, Province of Tucuman, Virgen de La Merced 196, San Miguel de Tucuman, Tucuman, Argentina
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Laurin A, Bulteau S, Caillet P, Artari P, Sauvaget A, Gollier-Briant F, Huon JF, Bonnot O. Psychotropic drugs consumption during 2020 COVID-19 pandemic and lockdowns: Evidence of a surprising resilience of the drugs delivery system in France. Eur Neuropsychopharmacol 2023; 73:48-61. [PMID: 37119562 PMCID: PMC10086109 DOI: 10.1016/j.euroneuro.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/01/2023]
Abstract
The COVID-19 pandemic imposed two lockdowns of eight and six weeks in France. While access to care was reduced during lockdown periods, these stressful situations with the pandemic and lockdown periods may have a negative impact on mental health, especially in vulnerable subgroups. Monitoring of psychotropic drugs consumption in France is a comprehensive and reliable tool for indirectly analyzing the mental health of French people. This historical cohort study (n = 767 147) investigated the short-term and long-term evolution of the weekly trend of psychotropic drugs users in 2020 by performing a Seasonal Trend decomposition time series analysis. Rate of progression of consumers per week increased from 186 in the last week of 2019 to 261 per week in the last week of 2020 (+40.3%). Our results did not show a significant break in psychotropic drugs consumption trends during the year 2020 and its two lockdowns. The increase in trend regarding psychotropic drugs consumptions was greatest in young people (<15 years) and patients not being socially deprived. Despite the increase in consumers with restrictive health measures, the French drugs delivery system has been able to adapt with the support of government and pharmacy network. This point should be kept in mind as the necessary reforms to the health care system are undertaken. The COVID-19 pandemic has a negative impact on mental health and two lockdowns occurred in France with reduced access to care. In this context, monitoring of psychotropic drugs consumption is a comprehensive and reliable tool for analyzing the mental health of French people. We hypothesized that the psychotropic drugs consumption has increased during the 2020 COVID-19 pandemic, testifying to French people mental health deterioration, with psychotropic drugs consumption breaks during lockdowns, especially during the first "grand national lockdown", due to the closure or difficulties for accessing to health care structures. By carrying out a historical cohort study among Pays de la Loire residents (n = 767 147), we investigated evolution of the weekly trend of psychotropic drugs users in 2020 compared to 2019 by performing a Seasonal Trend decomposition time series analysis. Between 2019 to 2020, we found a + 40.3% rate of progression of consumers per week. During the year 2020, changes in trend regarding psychotropic drugs consumptions was observed in various sub-groups, e.g. greater in the youngest (< 15 years), which may indicate a vulnerable group strongly impacted by COVID-19 negative consequences, and patients not being socially deprived, which may indicate a group with probably an easier access to care. Lockdown periods were not associated with a significant change in psychotropic drug use, suggesting a form of resilience in the French health care system to maintain its capacity to deliver psychotropic treatments. We mainly discussed that despite the increase in consumers and the policies of restricting access to care during lockdown periods, the French drugs delivery system has been able to adapt thanks to supportive policy actions (extension of the prescriptions validity without the need for a renewal by a physician during periods of lockdowns), an efficient pharmacy network with a collaborative practice of health actors that need to be developed and/or conserved to face potential future health crises.
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Affiliation(s)
- Andrew Laurin
- Nantes Université, CHU Nantes, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France.
| | - Samuel Bulteau
- Nantes Université, CHU Nantes, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000 Nantes, France
| | - Pascal Caillet
- Nantes Université, CHU Nantes, Service de Santé Publique, F-44000 Nantes, France
| | - Pascal Artari
- French National Health Insurance, Medical Department, DRSM Nantes, France
| | - Anne Sauvaget
- Nantes Université, CHU Nantes, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France
| | | | | | - Olivier Bonnot
- Nantes Université, CHU Nantes, Pharmacy, F-44000 Nantes, France
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Loyola Filho AID, Firmo JOA, Mambrini JVDM, Peixoto SV, Souza Junior PRBD, Nascimento MMGD. Use of psychotropic drugs by population in an area affected by the tailings dam rupture: Brumadinho Health Project. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220012. [PMID: 36327417 DOI: 10.1590/1980-549720220012.supl.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/17/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE To describe the consumption of psychotropic drugs in the adult population residing in Brumadinho, Minas Gerais, after the Vale dam collapse, which occurred in 2019. METHODS This is a cross-sectional study, part of the Brumadinho Health Project, developed in 2021, with a representative population-based sample of adults (18 years and over) residing in Brumadinho. A total of 2,805 adults with information on self-reported use of psychotropic drugs (antidepressants and anxiolytics-hypnotics/sedatives) in the last 15 days were included in the analysis. The prevalence of psychotropic drug use was estimated, and the most used psychotropic drugs were identified. Pearson's chi-square test (with Rao-Scott correction) was used to test associations between exposures and use of psychotropic drugs, considering a significance level of p<0.05. RESULTS The use of antidepressants (14.2%) was more common than the use of anxiolytics or hypnotics/sedatives (5.2%), with sertraline and fluoxetine being the most used antidepressants. The use of anxiolytics and hypnotics/sedatives was higher among residents who lived in the area directly affected by the dam's mud, and the use of any psychotropic drug was higher among those who lost a relative/friend in the disaster and assessed that their health worsened after the disaster, and among women. CONCLUSION The results of the study corroborate what was observed in other populations exposed to similar tragedies, regarding the pattern of associations and the of use of psychotropic drugs.
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Affiliation(s)
- Antônio Ignácio de Loyola Filho
- Fundação Oswaldo Cruz, Instituto René Rachou - Belo Horizonte (MG), Brazil
- Universidade Federal de Minas Gerais, School of Nursing - Belo Horizonte (MG), Brazil
| | | | | | - Sérgio Viana Peixoto
- Fundação Oswaldo Cruz, Instituto René Rachou - Belo Horizonte (MG), Brazil
- Universidade Federal de Minas Gerais, School of Nursing - Belo Horizonte (MG), Brazil
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Amiri H, Riyahifar S, Nakhaee N, Nekoei-Moghadam M. The long-term impact of the earthquake on substance use. Int J Emerg Med 2022; 15:44. [PMID: 36064323 PMCID: PMC9446523 DOI: 10.1186/s12245-022-00449-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022] Open
Abstract
Earthquake is associated with several health conditions such as posttraumatic stress disorder (PTSD), depression, and cardiovascular disease. However, the association between earthquakes and substance use has been less studied to date. We conducted a historical cohort study 17 years after the Bam earthquake by enrolling 818 households using multi-stage cluster sampling. The sample consisted of earthquake-exposed and non-exposed citizens. The ASSIST screening test was used to determine substance use. Logistic regression analysis was used to evaluate the association of variables of interest with substance use. Nearly 60% of the study subjects were female and the mean ± SD age of the sample was 46.6 ± 11.5 years. The prevalence of tobacco, alcohol, and other drug use in the exposed group was 19.5%, 24.9%, and 21.6%, respectively. The corresponding figures in the non-exposed group were 15.6%, 19.3%, and 20.1%, respectively (P > 0.05). The logistic regression model found no association between the history of earthquake exposure and the risk of any current drug use. Our results showed those 17 years after the Bam earthquake, there was no relationship between earthquake exposure and substance use.
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Affiliation(s)
- Hadis Amiri
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sevda Riyahifar
- Department of Biostatistics, School of Public Health, University of Medical Sciences, Tehran, Iran
| | - Nouzar Nakhaee
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Mahmoud Nekoei-Moghadam
- Department of Health in Emergency and Disasters, School of Healthcare Management and Medical Information, Kerman University of Medical Sciences, Kerman, Iran
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Guðmundsdóttir RB, Jónsson BGG, Valdimarsdottir U, Carlsen HK, Hlodversdottir H, Song H, Thordardottir EB, Pétursdóttir G, Briem H, Gislason T, Gudnason T, Thorsteinsson T, Zoega H, Hauksdóttir A. Medication use in populations exposed to the 2010 Eyjafjallajökull eruption: an interrupted time series analysis. BMJ Open 2022; 12:e059375. [PMID: 35534080 PMCID: PMC9086619 DOI: 10.1136/bmjopen-2021-059375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To assess the trends in medication use indicative of physical and psychological morbidity following the 2010 volcanic eruption in Eyjafjallajökull immediately after and during a 3-year period following the eruption. DESIGN Population-based register study. SETTING Eyjafjallajökull eruption in Iceland, 2007-2013. PARTICIPANTS All residents in Iceland who received at least one medication dispensing were identified. Residents of exposed areas were classified into exposure groups (individual-level data) and residents in other parts of Iceland were included as a non-exposed group (aggregated data). INTERVENTION/EXPOSURE Eyjafjallajökull erupted on 14 April 2010 and continued for 39 days, producing heavy ash fall in South Iceland. MAIN OUTCOME MEASURES Using interrupted time series analysis, we examined annual and quarterly changes in medicine use, measured as number of dispensed defined daily dose (DDD) per 1000 individuals. We calculated the level shift (immediate change) and change in slope from pre-eruption to post-eruption (long-term change) in medication dispensing. RESULTS Among exposed residents, there was a 6% decrease (95% CI -7% to -4%) in the annual number of dispensed DDDs 1-year post-eruption in the overall medication class, including analgesics (-5%, 95% CI -6% to -3%), hypnotics and sedatives (-9%, 95% CI -11% to -7%) and respiratory medications (-7%, 95% CI -9% to -5%; -8%, 95% CI -11% to -4%). Simultaneously, there was a 9% decrease (95% CI -14% to -4%) in the overall medication class among non-exposed residents. Moreover, among exposed residents, we observed change in slope of -4% (95% CI -7% to -1%) in the overall medication class, including for analgesics (-6%, 95% CI -8% to -3%) and other respiratory drugs (-10%, 95% CI -16% to -4%). CONCLUSION Our findings indicate that the eruption did not lead to increases in medication dispensing among residents of exposed areas, rather decreases for some medicine classes. The results should be interpreted with caution since the content of each eruption differs.
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Affiliation(s)
- Rebekka Björg Guðmundsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | | | - Unnur Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Hanne Krage Carlsen
- Environment and Natural Resources, University of Iceland, School of Health Sciences, Reykjavik, Iceland
- Section of Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gotheburg, Sweden
| | - Heidrun Hlodversdottir
- Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Huan Song
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Edda Bjork Thordardottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Guðrún Pétursdóttir
- Institute for Sustainability Studies, University of Iceland, Reykjavik, Iceland
| | - Haraldur Briem
- Centre for Health Threats and Communicable Diseases, Directorate of Health, Chief Epidemiologis, Reykjavik, Iceland
| | - Thorarinn Gislason
- Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
- Landspítali, National University Hospital of Iceland, Reykjavik, Iceland
| | - Thorolfur Gudnason
- Centre for Health Threats and Communicable Diseases, Directorate of Health, Chief Epidemiologis, Reykjavik, Iceland
- Centre for Health Threats and Communicable Diseases, Government of Iceland Directorate of Health, Reykjavik, Iceland
| | - Thröstur Thorsteinsson
- Environment and Natural Resources, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Helga Zoega
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
- Centre for Big Data Research in Health, Faculty of Medicine and Health, UNSW, Sydney, New South Wales, Australia
| | - Arna Hauksdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
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Maltais D, Généreux M, Roy M, Fortin G, Pouliot E, Bergeron-Leclerc C, Cherblanc J, Labra O, Lachance L, Paquette L. Psychological, Physical and Behavioral Health of Adults, 3 Years After Exposure to a Train Derailment. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221125765. [PMID: 36178048 PMCID: PMC9527988 DOI: 10.1177/00469580221125765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In July 2013, a train derailment profoundly disrupted the tranquility of the population of Lac-Mégantic for months and even years. In 2016, we conducted a representative population-based survey among 387 people from Lac-Mégantic and 413 from other municipalities with the aim to document psychological and physical health of adults exposed to the disaster. This article examines differences between 3 groups of respondents: those who were highly, moderately or not exposed to the train accident. Khi Square analyses, odds ratios and logistic regressions were used to examine differences between the 3 groups of respondents (high, moderate and no exposure). Results show that the level of exposure to this technological disaster is strongly associated with psychological suffering, post-traumatic growth, physical heath, drinking patterns, and use of prescribed and non-prescribed drugs. We can explain these results by the nature and cause of the event as well as its consequences.
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Affiliation(s)
| | | | - Mathieu Roy
- Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Eve Pouliot
- Université du Québec à Chicoutimi, Saguenay, QC, Canada
| | | | | | - Oscar Labra
- Université du Québec en Abitibi-Témiscamingue, Campus Rouyn-Noranda, Rouyn-Noranda, QC, Canada
| | - Lise Lachance
- Université du Québec à Chicoutimi, Saguenay, QC, Canada
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Hirschtritt ME, Slama N, Sterling SA, Olfson M, Iturralde E. Psychotropic medication prescribing during the COVID-19 pandemic. Medicine (Baltimore) 2021; 100:e27664. [PMID: 34713861 PMCID: PMC8556031 DOI: 10.1097/md.0000000000027664] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/04/2021] [Accepted: 10/11/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT This study examined changes in psychotropic medication use associated with the early months of the coronavirus disease 2019 (COVID-19) pandemic. Using Kaiser Permanente Northern California electronic health records, the authors identified adult patients with fills for psychotropic medications and a non-psychotropic comparator (statins) in the 13 weeks before and after the first-known COVID-19-related death in California (March 4, 2020). Generalized estimating equations were used to derive relative risk ratios (RRR) for medication fills compared with the prior year. Analyses were stratified by new and continued fills and patient characteristics. Among 2,405,824 patients, the mean (SD) age was 49.8 (17.9) years; 52.9% were female; 47.9% identified as White; 8.0% and 7.9% had anxiety and depression disorder diagnoses, respectively. Accounting for secular trends, in the 13 weeks following March 4, 2020, there were increased fills for trazodone (RRR = 1.03, 95% CI = 1.02, 1.04), decreased fills for benzodiazepines (RRR = 0.95, 95% CI = 0.94, 0.96) and hypnotics (RRR = 0.97, 95% CI = 0.96, 0.99), and stable fills for antidepressants (RRR = 1.00, 95% CI = 0.99, 1.00). Relative rates of new fills decreased across most medication classes and continued fills either remained stable or demonstrated non-clinically significant decreases. Patients aged ≥65 years demonstrated decreased fills for most medication classes. In the first 13 weeks of the COVID-19 pandemic, fills for most psychotropic medications remained constant or showed small changes relative to the previous year. Continued (compared with new) fills accounted for observed increases in some medication classes. Older adults demonstrated decreased fills of most medications.
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Affiliation(s)
- Matthew E. Hirschtritt
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
- The Permanente Medical Group, Oakland, CA
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Natalie Slama
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Stacy A. Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
| | - Mark Olfson
- Departments of Psychiatry and Epidemiology, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY
| | - Esti Iturralde
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
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10
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Fasciani I, Petragnano F, Aloisi G, Marampon F, Carli M, Scarselli M, Maggio R, Rossi M. Allosteric Modulators of G Protein-Coupled Dopamine and Serotonin Receptors: A New Class of Atypical Antipsychotics. Pharmaceuticals (Basel) 2020; 13:ph13110388. [PMID: 33202534 PMCID: PMC7696972 DOI: 10.3390/ph13110388] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 12/23/2022] Open
Abstract
Schizophrenia was first described by Emil Krapelin in the 19th century as one of the major mental illnesses causing disability worldwide. Since the introduction of chlorpromazine in 1952, strategies aimed at modifying the activity of dopamine receptors have played a major role for the treatment of schizophrenia. The introduction of atypical antipsychotics with clozapine broadened the range of potential targets for the treatment of this psychiatric disease, as they also modify the activity of the serotoninergic receptors. Interestingly, all marketed drugs for schizophrenia bind to the orthosteric binding pocket of the receptor as competitive antagonists or partial agonists. In recent years, a strong effort to develop allosteric modulators as potential therapeutic agents for schizophrenia was made, mainly for the several advantages in their use. In particular, the allosteric binding sites are topographically distinct from the orthosteric pockets, and thus drugs targeting these sites have a higher degree of receptor subunit specificity. Moreover, “pure” allosteric modulators maintain the temporal and spatial fidelity of native orthosteric ligand. Furthermore, allosteric modulators have a “ceiling effect”, and their modulatory effect is saturated above certain concentrations. In this review, we summarize the progresses made in the identification of allosteric drugs for dopamine and serotonin receptors, which could lead to a new generation of atypical antipsychotics with a better profile, especially in terms of reduced side effects.
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Affiliation(s)
- Irene Fasciani
- Department of Biotechnological and Applied Clinical Sciences, University of l’Aquila, 67100 L’Aquila, Italy; (I.F.); (F.P.); (G.A.)
| | - Francesco Petragnano
- Department of Biotechnological and Applied Clinical Sciences, University of l’Aquila, 67100 L’Aquila, Italy; (I.F.); (F.P.); (G.A.)
| | - Gabriella Aloisi
- Department of Biotechnological and Applied Clinical Sciences, University of l’Aquila, 67100 L’Aquila, Italy; (I.F.); (F.P.); (G.A.)
| | - Francesco Marampon
- Department of Radiotherapy, “Sapienza” University of Rome, Policlinico Umberto I, 00161 Rome, Italy;
| | - Marco Carli
- Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (M.C.); (M.S.)
| | - Marco Scarselli
- Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (M.C.); (M.S.)
| | - Roberto Maggio
- Department of Biotechnological and Applied Clinical Sciences, University of l’Aquila, 67100 L’Aquila, Italy; (I.F.); (F.P.); (G.A.)
- Correspondence:
| | - Mario Rossi
- Institute of Molecular Cell and Systems Biology, University of Glasgow, Glasgow G12 8QQ, UK;
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Beaglehole B, Moor S, Zhang T, Hamilton GJ, Mulder RT, Boden JM, Frampton CMA, Bell CJ. Impact of the Canterbury earthquakes on dispensing of psychiatric medication for children and adolescents: longitudinal quantitative study. Br J Psychiatry 2020; 216:151-155. [PMID: 31992378 DOI: 10.1192/bjp.2019.273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Natural disasters are increasing in frequency and impact; they cause widespread disruption and adversity throughout the world. The Canterbury earthquakes of 2010-2011 were devastating for the people of Christchurch, New Zealand. It is important to understand the impact of this disaster on the mental health of children and adolescents. AIMS To report psychiatric medication use for children and adolescents following the Canterbury earthquakes. METHOD Dispensing data from community pharmacies for the medication classes antidepressants, antipsychotics, anxiolytics, sedatives/hypnotics and methylphenidate are routinely recorded in a national database. Longitudinal data are available for residents of the Canterbury District Health Board (DHB) and nationally. We compared dispensing data for children and adolescents residing in Canterbury DHB with national dispensing data to assess the impact of the Canterbury earthquakes on psychotropic prescribing for children and adolescents. RESULTS After longer-term trends and population adjustments are considered, a subtle adverse effect of the Canterbury earthquakes on dispensing of antidepressants was detected. However, the Canterbury earthquakes were not associated with higher dispensing rates for antipsychotics, anxiolytics, sedatives/hypnotics or methylphenidate. CONCLUSIONS Mental disorders or psychological distress of a sufficient severity to result in treatment of children and adolescents with psychiatric medication were not substantially affected by the Canterbury earthquakes.
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Affiliation(s)
- Ben Beaglehole
- Senior Lecturer, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Stephanie Moor
- Senior Lecturer, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Tao Zhang
- Developer/Analyst, Planning and Funding Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Gregory J Hamilton
- Team Leader - Intelligence and Transformation, Planning and Funding Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Roger T Mulder
- Professor, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Joseph M Boden
- Associate Professor, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | | | - Caroline J Bell
- Associate Professor, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Maltais D, Lavoie-Trudeau É, Labra O, Généreux M, Roy M, Lansard AL, Fortin G. Medium-Term Effects of a Train Derailment on the Physical and Psychological Health of Men. Am J Mens Health 2019; 13:1557988319865363. [PMID: 31337254 PMCID: PMC6657134 DOI: 10.1177/1557988319865363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In July 2013, the derailment of a train caused the death of 47 people and the destruction of Lac-Mégantic's downtown area (Canada). Three years after this event, a population survey was conducted among a representative sample of 800 adults, including 282 men. Several significant differences were observed among respondents of a survey based on their level of exposure to this tragedy, including their physical (changes in physical health) and psychological health (post-traumatic stress disorder, mood and anxiety disorders, psychological distress, signs of depression, consultation of social workers and psychologists) as well as their use of prescribed (anxiolytics and antidepressants) and nonprescribed drugs. Such results can be explained by the nature, magnitude, and cause of the event.
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Affiliation(s)
- Danielle Maltais
- 1 Department of Human and Social Science, Université du Québec à Chicoutimi (UQAC), QC, Canada
| | - Étienne Lavoie-Trudeau
- 1 Department of Human and Social Science, Université du Québec à Chicoutimi (UQAC), QC, Canada
| | - Oscar Labra
- 2 Department of Human and Social Science, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Canada
| | - Mélissa Généreux
- 3 Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie - CHUS), QC, Canada.,5 Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, QC, Canada
| | - Mathieu Roy
- 4 Health Technology and Social Services Assessment Unit, Eastern Townships Integrated University Health and Social Services Centre, Université de Sherbrooke, QC, Canada.,5 Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, QC, Canada
| | - Anne-Lise Lansard
- 1 Department of Human and Social Science, Université du Québec à Chicoutimi (UQAC), QC, Canada
| | - Geneviève Fortin
- 1 Department of Human and Social Science, Université du Québec à Chicoutimi (UQAC), QC, Canada
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Han KM, Kim KH, Lee M, Lee SM, Ko YH, Paik JW. Increase in the prescription rate of antidepressants after the Sewol Ferry disaster in Ansan, South Korea. J Affect Disord 2017; 219:31-36. [PMID: 28505500 PMCID: PMC7112638 DOI: 10.1016/j.jad.2017.05.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 04/29/2017] [Accepted: 05/09/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Previous pharmaco-epidemiological studies have reported increases in the prescription of psychotropic medications after a disaster, reflecting post-disaster changes in psychiatric conditions and mental health service utilization. We investigated changes in the prescription of psychotropic medications in the Danwon district of Ansan city (Ansan Danwon) compared to a control community before and after the Sewol Ferry disaster on April 16, 2014. METHODS Data was collected from the Korean Health Insurance Review and Assessment Service database. We analyzed the prescription rates of psychotropic medications including antidepressants, anxiolytics, and sedatives/hypnotics, and investigated whether the time-series pattern of monthly prescriptions per 100,000 people was different in Ansan Danwon compared to that in Cheonan city after the Sewol Ferry disaster through difference-in-differences regression analysis. RESULTS Ansan Danwon showed a significantly greater increase (5.6%) in the prescription rate of antidepressants compared to Cheonan city following the Sewol Ferry disaster. There were no significant differences in changes in the prescription rates of anxiolytics or sedatives/hypnotics. In the secondary analysis, a significantly greater increase in the prescription rate of antipsychotics was observed in Ansan Danwon compared to a control community after the disaster. LIMITATIONS We could not exclude the possibility that other events influenced changes in the prescription rates of psychotropic medications during the study period. CONCLUSIONS Pharmaco-epidemiological studies on psychotropic medication prescription after a disaster provide important information about population-level mental health. Our results suggest that the Sewol Ferry disaster exerted a harmful effect on the mental health status of the affected community.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Kyoung-Hoon Kim
- Healthcare Data Analysis Division, Health Insurance Review and Assessment Service, Wonju, Republic of Korea
| | - Mikyung Lee
- Department of Psychiatry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang-Min Lee
- Department of Psychiatry, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Jong-Woo Paik
- Department of Psychiatry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Sahni V, Scott AN, Beliveau M, Varughese M, Dover DC, Talbot J. Public health surveillance response following the southern Alberta floods, 2013. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2016; 107:e142-e148. [PMID: 27526210 PMCID: PMC6972453 DOI: 10.17269/cjph.107.5188] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 05/22/2016] [Accepted: 01/17/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In June of 2013, southern Alberta underwent flooding that affected approximately 100,000 people. We describe the process put in place for public health surveillance and assessment of the impacts on health. METHODS Public health surveillance was implemented for the six-week period after the flood to detect anticipated health events, including injuries, mental health problems and infectious diseases. Data sources were emergency departments (EDs) for presenting complaints, public health data on the post-exposure administration of tetanus vaccine/immunoglobulin, administrative data on prescription drugs, and reportable diseases. RESULTS An increase in injuries was detected through ED visits among Calgary residents (rate ratio [RR] 1.28, 95% confidence interval [CI]: 1.14-1.43) and was supported by a 75% increase in the average weekly administration of post-exposure prophylaxis against tetanus. Mental health impacts in High River residents were observed among females through a 1.64-fold (95% CI: 1.11-2.43) and 2.32-fold (95% CI: 1.45-3.70) increase in new prescriptions for anti-anxiety medication and sleep aids respectively. An increase in sexual assaults presenting to EDs (RR 3.18, 95% CI: 1.29-7.84) was observed among Calgary residents. No increases in infectious gastrointestinal disease or respiratory illness were identified. Timely identification and communication of surveillance alerts allowed for messaging around the use of personal protective equipment and precautions for personal safety. CONCLUSION Existing data sources were used for surveillance following an emergency situation. The information produced, though limited, was sufficiently timely to inform public health decision-making.
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Affiliation(s)
- Vanita Sahni
- Alberta Ministry of Health, 23rd Floor, ATB Place, 10025 Jasper Avenue NW, Edmonton, AB, T5J 1S6, Canada.
| | - Allison N Scott
- Alberta Ministry of Health, 23rd Floor, ATB Place, 10025 Jasper Avenue NW, Edmonton, AB, T5J 1S6, Canada
| | - Marie Beliveau
- Alberta Ministry of Health, 23rd Floor, ATB Place, 10025 Jasper Avenue NW, Edmonton, AB, T5J 1S6, Canada
| | - Marie Varughese
- Alberta Ministry of Health, 23rd Floor, ATB Place, 10025 Jasper Avenue NW, Edmonton, AB, T5J 1S6, Canada
| | - Douglas C Dover
- Alberta Ministry of Health, 23rd Floor, ATB Place, 10025 Jasper Avenue NW, Edmonton, AB, T5J 1S6, Canada
| | - James Talbot
- Alberta Ministry of Health, 23rd Floor, ATB Place, 10025 Jasper Avenue NW, Edmonton, AB, T5J 1S6, Canada
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Beaglehole B, Bell C, Frampton C, Hamilton G, McKean A. The impact of the Canterbury earthquakes on prescribing for mental health. Aust N Z J Psychiatry 2015; 49:742-50. [PMID: 26041790 DOI: 10.1177/0004867415589794] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate the impact of the Canterbury earthquakes on the mental health of the local population by examining prescribing patterns of psychotropic medication. METHOD Dispensing data from community pharmacies for antidepressants, antipsychotics, anxiolytics and sedatives/hypnotics are routinely recorded in a national database. The close relationship between prescribing and dispensing provides the opportunity to assess prescribing trends for Canterbury compared to national data and therefore examines the longitudinal impact of the earthquakes on prescribing patterns. RESULTS Short-term increases in the use of anxiolytics and sedatives/hypnotics were observed after the most devastating February 2011 earthquake, but this effect was not sustained. There were no observable effects of the earthquakes on antidepressant or antipsychotic dispensing. CONCLUSION Short-term increases in dispensing were only observed for the classes of anxiolytics and sedatives/hypnotics. No sustained changes in dispensing occurred. These findings suggest that long-term detrimental effects on the mental health of the Canterbury population were either not present or have not resulted in increased prescribing of psychotropic medication.
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Affiliation(s)
- Ben Beaglehole
- Department of Psychological Medicine, University of Otago - Christchurch, Christchurch, New Zealand
| | - Caroline Bell
- Department of Psychological Medicine, University of Otago - Christchurch, Christchurch, New Zealand
| | - Christopher Frampton
- Department of Psychological Medicine, University of Otago - Christchurch, Christchurch, New Zealand
| | - Greg Hamilton
- Canterbury District Health Board, Christchurch, New Zealand
| | - Andrew McKean
- Canterbury District Health Board, Christchurch, New Zealand
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Giuliani AR, Mattei A, Santilli F, Clori G, Scatigna M, Fabiani L. Well-being and perceived quality of life in elderly people displaced after the earthquake in L'Aquila, Italy. J Community Health 2014; 39:531-7. [PMID: 24302517 PMCID: PMC4000418 DOI: 10.1007/s10900-013-9793-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
On 6 April 2009, the city of L’Aquila was hit by a violent earthquake that destroyed almost all of its medieval centre, and the surviving inhabitants were evacuated and relocated in temporary quarters or undamaged homes. The aim of this study was to investigate the perceived quality of life of the elderly population 3 years after the earthquake in relation to the social and logistic issues of new housing. The study was carried out between October 2011 and March 2012, and involved 571 subjects aged over 65 years living in the municipality of L’Aquila. The interviews took place in the surgeries of general practitioners and the city’s Department of Prevention and Vaccination in the anti-influenza immunisation period. The instrument used was a 36-item questionnaire with closed, multiple choice answers divided into the following sections: demographics, everyday activities, health and perceived health, and the quality of life in the city. The results show that, 3 years after the earthquake, the elderly population living in the new towns and temporary housing of L’Aquila have a worse perception of their quality of life than the others. They feel a certain social isolation and wish to live elsewhere. Governments faced with the problems arising from a natural calamity should take into account all of the elements making up a good quality of life and, before making choices whose impact cannot be changed, consider both their immediate and long-term social consequences.
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Affiliation(s)
- Anna Rita Giuliani
- Department of Medicine, Health and Environment Sciences, University of L'Aquila, Viale S. Salvatore Edificio 6, 67100, L'Aquila, Italy,
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Diène E, Geoffroy-Perez B, Cohidon C, Gauvin S, Carton M, Fouquet A, Fatras JY, Imbernon E. Psychotropic drug use in a cohort of workers 4 years after an industrial disaster in France. J Trauma Stress 2014; 27:430-7. [PMID: 25158636 DOI: 10.1002/jts.21940] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Two years after the 2001 Toulouse industrial disaster, a longitudinal study was set up to evaluate the impact of the disaster. The current substudy examines the medium-term impact (5 years) the incident had on the mental health of 3,004 participants. As part of the monitoring, data relating to the psychotropic drug use of 2,494 participants were collected from administrative databases 4 years after the disaster. Use of psychotropics was higher among women for anxiolytics (10.4% for men and 15.0% for women), hypnotics (10.5% and 17.0%), and antidepressants (7.6% and 11.2%). Exposure to the disaster, especially proximity to the exposure, was significantly associated with the use of antidepressants in men, OR = 3.22, 95% CI[1.57, 6.61]. This was also the case for other exposure factors (saw dead or injury, injured, home damage, death or injury loved one, psychological disorders, exposure toxic fumes): range of OR 1.75 to 2.52 in men, 1.48 to 1.62 in women. In conclusion, this study highlights the medium-term psychological impact of an industrial disaster on psychotropic drug use and the potential for using medical records data as a means for tracking postdisaster mental health.
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Affiliation(s)
- Eloi Diène
- Institut de Veille Sanitaire (InVS), Saint-Maurice, France
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Abstract
BACKGROUND Given the well-documented acute increase in psychopathology after disasters as well as the greater likelihood of suicide among persons with psychopathology, it may be expected that suicide rates also rise after such events. AIM To investigate the suicide rate 1 year after the April 2009 earthquake that struck L'Aquila (Italy). METHODS Suicide rates were collected from administrative data sets of the Italian National Institute of Statistics for the years 2004 through 2009. RESULTS The number and rate of suicides during 2009 are the lowest since 2004 - and significantly lower than the two prequake years. CONCLUSIONS The findings suggest that an investigation of resilience and posttraumatic personal growth might be useful in guiding public health efforts on suicidal prevention in the aftermath of disasters.
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Trifirò G, Italiano D, Alibrandi A, Sini G, Ferrajolo C, Capuano A, Spina E, Rossi A, L'Aquila group. Effects of L'Aquila earthquake on the prescribing pattern of antidepressant and antipsychotic drugs. Int J Clin Pharm 2013; 35:1053-62. [PMID: 24045997 DOI: 10.1007/s11096-013-9822-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 06/27/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Natural disasters provoke an increase in mental and medical disorders in survivors. Monitoring drug prescription changes after natural disasters can provide an indirect evaluation of trauma impact in the population. Moreover, it could be useful to both identify risk categories that require special assistance and assess possible drug abuse or misuse. OBJECTIVE To assess the effects of earthquake that occurred on April 6, 2009 on the use of antidepressant and antipsychotic drugs in the province of L'Aquila. SETTING General population of L'Aquila and Caserta provinces from Southern Italy. METHOD In a retrospective, drug utilization study we identified all the persons who received at least one dispensing of antidepressant and/or antipsychotic drugs during the period April 1st, 2008-March 31st, 2010. MAIN OUTCOME MEASURE The monthly prevalence of use of these drugs, 1 year prior and after the date of earthquake in L'Aquila was compared between the two provinces, L'Aquila and Caserta. All the analyses were stratified by age groups, gender and drug classes. RESULTS We observed an increase in the use of antipsychotic drugs and, to lesser extent, of antidepressant agents (mostly typicals and tryciclics, respectively) in the first 2 months after the earthquake in L'Aquila but not in Caserta. This increase was almost two-fold higher in women older than 75 years. After the first 2 months from the earthquake, the use of antidepressants and antipsychotics was stabilized at the pre-earthquake levels in L'Aquila. CONCLUSION The earthquake determined a short-term increase in the use of antipsychotics (mostly haloperidol and promazine) and, to lesser extent, of antidepressants (i.e. tryciclics), especially in older women of L'Aquila.
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Affiliation(s)
- Gianluca Trifirò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy,
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Increase in psychotropic drug deliveries after the Xynthia storm, France, 2010. Prehosp Disaster Med 2013; 28:428-33. [PMID: 23803498 DOI: 10.1017/s1049023x13008662] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION During the night of February 27 and the early morning of February 28, 2010, 15 coastal municipalities situated in two French departments, Vendée and Charente-Maritime, were violently stricken by a severe windstorm named "Xynthia." This storm caused the death of 12 individuals in Charente-Maritime and 29 people in Vendée. Houses, agricultural fields, and shellfish companies were severely flooded with seawater. Several thousand people temporarily had to leave their homes. The objective of this study was to estimate the short-term mental health impact of Xynthia, in terms of psychotropic drug delivery, on the resident population of the 15 coastal municipalities severely hit by the flooding. METHODS The French national health insurance database was used to calculate a daily number of new psychotropic treatments from September 1, 2008 through December 24, 2010. New treatments were calculated for each of the following European Pharmaceutical Marketing Research Association (EphMRA) classes: tranquilizers (N05C), hypnotics (N05B), and antidepressants (N06A). A period of three weeks following the storm was defined as the exposure period. A generalized additive model with a Poisson distribution that allows for over-dispersion was used to analyze the correlation between the Xynthia variable and the number of new psychotropic treatments. RESULTS With a relative risk (RR) of 1.54 (95% CI, 1.39-1.62) corresponding to an estimate of 409 new deliveries of psychotropic drugs during the three weeks following the storm, this study confirms the importance of the psychological impact of Xynthia. This impact is seen on all three classes of psychotropic drugs studied. The impact is greater for tranquilizers (RR of 1.78; 95% CI, 1.59-1.89) than for hypnotics (RR of 1.53; 95% CI, 1.31-1.67) and antidepressants (RR of 1.26; 95% CI, 1.06-1.40). The RR was higher for females than for males. CONCLUSION This study shows the importance of the psychological impact of the storm as observed clinically by health workers who intervened in the field during the aftermath of Xynthia. It confirms that administrative databases can be used to show a health impact of a disaster even at a local level. This is one more step in the direction of a comprehensive strategy of collecting information to allow the assessment of the health impact of an extreme event, the detection of vulnerable populations, and the orientation of the short-, mid- and long-term public health response.
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Rate of prescription of antidepressant and anxiolytic drugs after Cyclone Yasi in North Queensland. Prehosp Disaster Med 2012; 27:519-23. [PMID: 23009700 DOI: 10.1017/s1049023x12001392] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The need to manage psychological symptoms after disasters can result in an increase in the prescription of psychotropic drugs, including antidepressants and anxiolytics. Therefore, an increase in the prescription of antidepressants and anxiolytics could be an indicator of general psychological distress in the community. PURPOSE The purpose of this study was to determine if there was a change in the rate of prescription of antidepressant and anxiolytic drugs following Cyclone Yasi. METHODS A quantitative evaluation of new prescriptions of antidepressants and anxiolytics was conducted. The total number of new prescriptions for these drugs was calculated for the period six months after the cyclone and compared with the same six month period in the preceding year. Two control drugs were also included to rule out changes in the general rate of drug prescription in the affected communities. RESULTS After Cyclone Yasi, there was an increase in the prescription of antidepressant drugs across all age and gender groups in the affected communities except for males 14-54 years of age. The prescription of anxiolytic drugs decreased immediately after the cyclone, but increased by the end of the six-month post-cyclone period. Control drug prescription did not change. CONCLUSION There was a quantifiable increase in the prescription of antidepressant drugs following Cyclone Yasi that may indicate an increase in psychosocial distress in the community.
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Cardiovascular and cerebrovascular events pre- and post-earthquake of 6 April 2009: the Abruzzo's experience. Am J Hypertens 2012; 25:556-60. [PMID: 22318513 DOI: 10.1038/ajh.2012.4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND On 6 April 2009, an earthquake occurred in Abruzzo, a small region in the middle-east of Italy. Its chief town, L'Aquila, was the epicenter. We carried out an observational analysis to evaluate the potential association between the earthquake and the rate of cardiovascular and cerebrovascular admissions of the residents in the province of L'Aquila. METHODS We used administrative discharge data, extracting all admissions made from 6 April to 31 July 2008 (pre-earthquake control period) or from 6 April to 31 July 2009 (post-earthquake period), assigned to diagnosis-related groups (DRGs) related to cardiovascular or cerebrovascular diseases. RESULTS The overall number of hospitalizations for cardio- or cerebrovascular diseases by residents in L'Aquila before and after the earthquake was 10,833. In the whole region, the hospitalization rate was slightly lower in 2009 (-0.9%), whereas only in the local health unit (LHU) of L'Aquila it showed an increase by +13.2% (P < 0.01), essentially due to cardiovascular diseases (+21.9%) in elderly people (+26.9%; P < 0.01). The proportion of the main comorbidities in the admissions for cardiovascular diseases of the residents in L'Aquila significantly increased (P = 0.03), but no significant differences could be observed for each comorbidity separately. CONCLUSIONS Our study supports previous findings of an association between earthquakes and an increase in cardiovascular diseases in the elderly.
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Abstract
The authors describe their experience working and living in L'Aquila, where at 3.32 a.m., early in the morning of 6 April 2009, a 6.3 Richter magnitude earthquake caused serious damages to this 13th century town (with a population of 72 000 and a health district of 103 788), in the mountainous Abruzzo region and to several medieval hill villages in the surrounding areas: 309 residents were killed, over 1600 were injured, 66 000 residents were displaced, and, the centre of L'Aquila, the main historical and artistic centre of Abruzzo, was totally destroyed. Here is described the work done at the Psychiatric Unit of the General Hospital of L'Aquila and in the University. The Authors report the incidence rate of Acute Stress Disorder (ASD) in help-seekers (full ASD 4.9%, and partial ASD 39.3%), and of post-traumatic stress disorder (PTSD) found in different samples of population (range 12-37.5). The authors express their consideration about which real-world variables can reflect the population distress and the naturalistic process of recovery in such natural disasters. After the earthquake they hypothesize that a lot of residents had found their way to recover through 'writing, telling the story', by analogy with what narrative medicine asserts, thus estimating the positive effect of 'emotional disclosure' on health. A large number of materials (books, web-blogs, videos) were produced by residents and a database of memories was implemented. The suffering and struggle to recover in the aftermaths of a traumatic experience often yields remarkable transformations and positive growth. From this point of view, the authors underline the increased virtual relationships of residents through Facebook, to cope with the loss of previous social relationships, to get information about recreational opportunities, or to get organized for public events, despite their displacement. Many collective demonstrations were organized and showed the will to actively participate to the processes of reconstruction of the civil and scientific life of the town. The authors stress the need to prevent natural disasters, instead of preventing mental disorders following natural disasters, reporting that seven Italian seismologists and scientists are on trial for manslaughter, accused to have failed to evaluate the true risks of L'Aquila earthquake.
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Dell'osso L, Carmassi C, Stratta P, Massimetti G, Akiskal KK, Akiskal HS, Maremmani I, Rossi A. Gender Differences in the Relationship between Maladaptive Behaviors and Post-Traumatic Stress Disorder. A Study on 900 L' Aquila 2009 Earthquake Survivors. Front Psychiatry 2012; 3:111. [PMID: 23293608 PMCID: PMC3537190 DOI: 10.3389/fpsyt.2012.00111] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 12/12/2012] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) represents one of the most frequently psychiatric sequelae to earthquake exposure. Increasing evidence suggests the onset of maladaptive behaviors among veterans and adolescents with PTSD, with specific gender differences emerging in the latter. Aims of the present study were to investigate the relationships between maladaptive behaviors and PTSD in earthquake survivors, besides the gender differences in the type and prevalence of maladaptive behaviors and their association with PTSD. METHODS 900 residents of the town of L'Aquila who experienced the earthquake of April 6th 2009 (Richter Magnitude 6.3) were assessed by means of the Trauma and Loss Spectrum-Self Report (TALS-SR). RESULTS Significantly higher maladaptive behavior prevalence rates were found among subjects with PTSD. A statistically significant association was found between male gender and the presence of at least one maladaptive behavior among PTSD survivors. Further, among survivors with PTSD significant correlations emerged between maladaptive coping and symptoms of re-experiencing, avoidance and numbing, and arousal in women, while only between maladaptive coping and avoidance and numbing in men. CONCLUSIONS Our results show high rates of maladaptive behaviors among earthquake survivors with PTSD suggesting a greater severity among men. Interestingly, post-traumatic stress symptomatology appears to be a better correlate of these behaviors among women than among men, suggesting the need for further studies based on a gender approach.
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Affiliation(s)
- Liliana Dell'osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
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Temperament and Character Inventory – Revised (TCI–R) 1year after the earthquake of L’Aquila (Italy). PERSONALITY AND INDIVIDUAL DIFFERENCES 2011. [DOI: 10.1016/j.paid.2011.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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