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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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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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Benistand P, Vorilhon P, Laporte C, Bouillon-Minois JB, Brousse G, Bagheri R, Ugbolue UC, Baker JS, Flaudias V, Mulliez A, Dutheil F. Effect of the COVID-19 pandemic on the psychotropic drug consumption. Front Psychiatry 2022; 13:1020023. [PMID: 36590615 PMCID: PMC9797694 DOI: 10.3389/fpsyt.2022.1020023] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Although the COVID-19 pandemic has had a negative impact on mental health, there is no comprehensive longitudinal study of the entire population of a country without selection bias. OBJECTIVE The objective of this study was to evaluate the prescription of psychotropic drugs during the COVID-19 pandemic, using data from the French national health data system (SNDS). DESIGN SETTINGS AND PARTICIPANTS Prescriptions for psychotropic drugs (antidepressants, anxiolytics, hypnotics, and antipsychotics) from 1 January 2015 to 30 September 2021 were collected from administrative data provided by the SNDS. This database includes more than 99% of the French population, i.e., 67 million people. The data were analyzed using an interrupted time series analysis (ITSA) model. MAIN OUTCOMES AND MEASURES Consumption of psychotropic drugs was aggregated in months and expressed in number of boxes per thousand inhabitants. RESULTS During the study period, more than 1.3 billion boxes of psychotropic medications were dispensed. Comparison of psychotropic drug dispensing before and after the pandemic showed a relative increase of 0.76 (95 CI 0.57 to 0.95, p<0.001) boxes per month per thousand inhabitants, all classes of psychotropic drugs combined. Three classes saw their consumption increase in an almost similar proportion, respectively, by 0.23 (0.15 to 0.32, p<0.001) boxes for antidepressants, 0.27 (0.20 to 0.34, p<0.001) boxes for anxiolytics and 0.23 (0.17 to 0.30, p<0.001) boxes for hypnotics. The change in antipsychotic consumption was very small, with an increase of 0.04 boxes (0.02 to 0.06, p = 0.001) per month per thousand population. CONCLUSION AND RELEVANCE The COVID-19 pandemic had led to an increase in the consumption of psychotropic drugs, confirming the significant impact of the pandemic on the mental health of the general population.
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Affiliation(s)
- Paul Benistand
- Département de Médecine Générale, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Research Unit AutomédiCation aCcompagnement Pluriprofessionnel PatienT (ACCePPT), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Catherine Laporte
- Clermont Auvergne INP, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, Centre National de Recherche Scientifique (CNRS), Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jean-Baptiste Bouillon-Minois
- Centre National de Recherche Scientifique (CNRS), Laboratoire de Psychologie Sociale et Cognitive (LaPSCo), Physiological and Psychosocial Stress, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Georges Brousse
- Clermont Auvergne INP, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, Centre National de Recherche Scientifique (CNRS), Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Ukadike Chris Ugbolue
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, United Kingdom
| | - Julien S Baker
- Department of Physical Education and Health, Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Valentin Flaudias
- Laboratoire de Psychologie des Pays de la Loire, Université de Nantes, Nantes, France
| | - Aurélien Mulliez
- Direction de la Recherche Clinique et Innovations Biostatistics, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, Clermont-Ferrand, France
| | - Frédéric Dutheil
- Centre National de Recherche Scientifique (CNRS), Laboratoire de Psychologie Sociale et Cognitive (LaPSCo), Physiological and Psychosocial Stress, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France
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Revet A, Moulis G, Raynaud JP, Bui E, Lapeyre-Mestre M. Use of the French national health insurance information system for research in the field of mental health: Systematic review and perspectives. Fundam Clin Pharmacol 2021; 36:16-34. [PMID: 33998708 DOI: 10.1111/fcp.12696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE This systematic review registered in PROSPERO (CRD42021225296) aimed to describe the use of the French national health insurance information system, which covers the entire French population (67 million inhabitants), for research in the field of mental health. METHODS Three electronic databases and a journal hand-search identified 15 265 articles from January 1, 2003 (year of creation of the database) to October 31, 2020. Studies of any design were eligible for inclusion provided that they (i) made use of at least one component of the French health insurance database and (ii) focused on a topic in near and far connection with the field of mental health in France. Database used, design and methods, study period, population, key findings, and type of use for medical research were described. RESULTS A total of 152 studies were included in the review analysis. There was an increase in the number of published articles over time throughout the studied period. Studies focusing on adults (n = 139) largely outnumbered those focusing on children and adolescents (n = 11). Pharmacoepidemiological studies were by far the most frequent (n = 123), followed by methodological studies (n = 23), epidemiological studies (n = 17), and health economics studies (n = 3). The most studied psychotropic drugs were antidepressants (n = 27), anxiolytics (n = 27), and opioids (n = 25) while fewer studies focused on methylphenidate (n = 6) and on mood stabilizers (n = 5). Few studies specifically focused on psychiatric disorders, mainly depression (n = 4), suicide (n = 4), and psychotic disorders (n = 3). CONCLUSION This systematic review highlighted a relatively poor exploitation of the Système national des données de santé database in the field of psychiatric research with regard to the great possibilities it offers, with a clear lag in certain fields such as epidemiological or health economics studies and in specific populations, in particular children and adolescents.
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Affiliation(s)
- Alexis Revet
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Toulouse, France.,CERPOP, Inserm, UPS, Université de Toulouse, Toulouse, France.,CIC 1436, Team PEPSS "Pharmacologie En Population cohorteS et biobanqueS", Toulouse University Hospital, Toulouse, France
| | - Guillaume Moulis
- CIC 1436, Team PEPSS "Pharmacologie En Population cohorteS et biobanqueS", Toulouse University Hospital, Toulouse, France.,Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Jean-Philippe Raynaud
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Toulouse, France.,CERPOP, Inserm, UPS, Université de Toulouse, Toulouse, France
| | - Eric Bui
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Caen University Hospital, University of Caen Normandy, Caen, France
| | - Maryse Lapeyre-Mestre
- CIC 1436, Team PEPSS "Pharmacologie En Population cohorteS et biobanqueS", Toulouse University Hospital, Toulouse, France
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Herin F, Othenin J, Jouanjus E, Rousseau V, Niezborala M, Lapeyre-Mestre M. Evolution of medication consumption in a working environment in France: Results of the four waves of the "Drugs and Work" study (1986-2016). Pharmacoepidemiol Drug Saf 2021; 30:661-668. [PMID: 33625778 DOI: 10.1002/pds.5211] [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: 03/02/2020] [Accepted: 02/18/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Previous studies in the working environment have underlined the high prevalence of drug consumption. The aim of this study was to present the main characteristics of this consumption in French workers and to identify changes from the 1986, 1996, 2006 and 2016 surveys. METHODS The design was a repeated cross-sectional study in 1986, 1996, 2006 and 2016. At each wave, demographic and socio-professional characteristics, self-reported consumption of medications during the week before the occupational medical visit, and perceived difficult working conditions and extraprofessional problems were collected among a sample of workers. Factors associated with consumption of any drug and of main therapeutic classes were investigated through multivariate logistic regression models, using 2016 as the reference for investigating temporal trends. RESULTS Prevalence of use of any drug was significantly higher in 2016, with marked changes observed in comparison with 1986: absolute decrease of psychotropic (-5.1%, p < 0.0001), antibiotics (-2.7%, p < 0.0001) and cardiovascular drug use (-3.8%, p < 0.0001), increase of analgesic use (+8.3%, p < 0.0001). Difficult working conditions, age and female gender were independently associated with analgesic drug use, and extraprofessional problems and female gender associated with psychotropic drug use. CONCLUSIONS This analysis of self-reported drug use in the working environment illustrates the global patterns of medication use in a French active population over 3 decades. The favorable development in the level of consumption of psychotropic drugs should not underestimate the attention to be paid to the determinants of chronic consumption, or possible transfers to less stigmatized medications.
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Affiliation(s)
- Fabrice Herin
- Service Des Maladies Professionnelles Et Environnementales, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,UMR-Inserm 1295, Université De Toulouse, Toulouse, France
| | - Jerome Othenin
- Service Des Maladies Professionnelles Et Environnementales, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Emilie Jouanjus
- UMR-Inserm 1295, Université De Toulouse, Toulouse, France.,Service De Pharmacologie Médicale Et Clinique, CIC 1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Vanessa Rousseau
- Service De Pharmacologie Médicale Et Clinique, CIC 1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | | | - Maryse Lapeyre-Mestre
- UMR-Inserm 1295, Université De Toulouse, Toulouse, France.,Service De Pharmacologie Médicale Et Clinique, CIC 1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,PharmacoEPi cohortS and biobankS (PEPSS), CIC de Toulouse, Université Paul Sabatier-Toulouse 3, Toulouse, France
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Lee E, Lee H. Disaster awareness and coping: Impact on stress, anxiety, and depression. Perspect Psychiatr Care 2019; 55:311-318. [PMID: 30648274 DOI: 10.1111/ppc.12351] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 12/19/2018] [Accepted: 12/24/2018] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study examines disaster awareness and coping among college students to identify their influence on stress, anxiety, and depression. DESIGN AND METHODS Overall, 291 college students participated. A multiple regression analysis was conducted to analyze the influence of disaster awareness and coping on stress, anxiety, and depression. FINDINGS In the multiple regression model, anxiety, and depression were influenced by an awareness of natural and social disasters, level of perception of disaster response strategies, and level of information relating to disasters. PRACTICE IMPLICATIONS It is important to deliver effective information on disaster response and strategies to prevent disaster-related mental health issues.
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Affiliation(s)
- Eunmi Lee
- Department of Nursing, Hoseo University, Asan-si, Chungcheongnam-do, Republic of Korea
| | - Haeyoung Lee
- Red Cross College of Nursing, Chung-Ang University, Dongjak-gu, Seoul, Republic of Korea
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Abstract
Responding to critical incidents may result in 5.9-22% of first responders developing psychological trauma and posttraumatic stress disorder. These impacts may be physical, mental, and/or behavioral. This population remains at risk, given the daily occurrence of critical incidents. Current treatments, primarily focused on combat and rape victims, have included single and double interventions, which have proven helpful to some but not all victims and one standard of care has remained elusive. However, even though the need is established, research on the treatment interventions of first responders has been limited. Given the multiplicity of impacts from psychological trauma and the inadequacies of responder treatment intervention research thus far, this paper proposes a paradigmatic shift from single/double treatment interventions to a multi-modal approach to first responder victim needs. A conceptual framework based on psychological trauma is presented and possible multi-modal interventions selected from the limited, extant first responder research are utilized to illustrate how the approach would work and to encourage clinical and experimental research into first responder treatment needs.
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