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Ward R, Brookes VJ, Rahman KM. Are we joining the One Health dots? A scoping review of research on the one health effects of extreme weather events in eastern Australia. Front Vet Sci 2024; 11:1423501. [PMID: 39135900 PMCID: PMC11317470 DOI: 10.3389/fvets.2024.1423501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 07/11/2024] [Indexed: 08/15/2024] Open
Abstract
Extreme weather events such as floods, bushfires, cyclones, and drought, are projected to increase in eastern Australia. Understanding how these events influence the combined, sustainable well-being of humans, animals, and ecosystems - that is One Health - will enable development of transdisciplinary and ultimately more effective interventions. A scoping review was conducted to explore the research associated with the effects of extreme weather events in eastern Australia using a One Health lens, specifically identifying the type of extreme weather events studied, the research conducted in the context of One Health, and gaps to inform improved One Health implementation. The review followed JBI guidelines (based on PRISMA). Eligible research was peer-reviewed, in English, and published since 2007, in which primary research studies investigated the impact of extreme weather events in eastern Australia on at least two of ecosystems, human health, and animal health. Using structured search terms, six databases were searched. Following removal of duplicates, 870 records were screened by two reviewers. Eleven records were eligible for data extraction and charting. The scope of extreme weather events studied was relatively limited, with studies in flood and bushfire settings predominating, but relatively little research on cyclones. Major health themes included more than the impact of extreme weather events on physical health (zoonotic and vector-borne diseases) through investigation of social well-being and mental health in the context of the human-animal bond in evacuation behaviors and drought. Research gaps include studies across a broader range of extreme weather events and health topics, as well as a more comprehensive approach to including the impacts of extreme weather events on all three domains of One Health. The limited research focus inevitably translates to limited recommendations for policy, planning and response to manage extreme weather event emergencies. Given the expected increase in frequency of these events, there is a critical need for more comprehensive primary research to better identify strategies and facilitate implementation of One Health promotion for improved outcomes in extreme weather event emergencies.
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Affiliation(s)
- Rebecca Ward
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
- Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
| | - Victoria J. Brookes
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown, NSW, Australia
- Sydney Infectious Diseases Institute, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Kazi Mizanur Rahman
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
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De Bandt D, Haile SR, Devillers L, Bourrion B, Menges D. Prescriptions of antidepressants and anxiolytics in France 2012-2022 and changes with the COVID-19 pandemic: interrupted time series analysis. BMJ MENTAL HEALTH 2024; 27:e301026. [PMID: 38413052 PMCID: PMC10900346 DOI: 10.1136/bmjment-2024-301026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Depression and anxiety have increased in prevalence since the start of the COVID-19 pandemic. OBJECTIVE To evaluate the consumption of antidepressants and anxiolytics from 2012 to 2022 and the pandemic's potential impact in France. METHODS We conducted an interrupted time series analysis of routine drug sales data (Medic'AM) from all French outpatient pharmacies from 2012 to 2022. We investigated trends in defined daily doses of antidepressants and anxiolytics sold per 1000 inhabitants (DDD/TID) and related expenditures before and after pandemic onset and in relation with stringency of pandemic mitigation measures. Analyses were performed descriptively and using segmented linear regression, autoregressive and autoregressive integrated moving average models. FINDINGS From 2012 to 2019, overall monthly antidepressant sales increased (+0.02 DDD/TID) while monthly anxiolytic sales decreased (-0.07 DDD/TID). With pandemic onset, there was a relevant and persisting trend increase (+0.20 DDD/TID per month) for antidepressant sales overall, with an estimated excess of 112.6 DDD/TID sold from May 2020 until December 2022. Anxiolytic sales were elevated from February 2020 throughout the pandemic but returned to expected levels by December 2022, with an estimated excess of 33.8 DDD/TID. There was no evident association between stringency and antidepressant or anxiolytic sales. CONCLUSIONS This study showed a protracted trend increase in the consumption of antidepressants since pandemic onset, while increases in anxiolytic consumption were temporary. CLINICAL IMPLICATIONS We provide evidence that the COVID-19 pandemic may have had long-lasting consequences on the prevalence and treatment of depression and anxiety disorders, requiring further actions by researchers and policy-makers to address this potential public mental health crisis.
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Affiliation(s)
- David De Bandt
- General Practice, Versailles Saint-Quentin-en-Yvelines University Faculty of Science, Montigny le Bretonneux, France
- Center for Research in Epidemiology and Population Health, The French National Institute of Health and Medical Research, INSERM U1018 Equipe 11, Villejuif, Île-de-France, France
| | - Sarah R Haile
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Louise Devillers
- General Practice, Versailles Saint-Quentin-en-Yvelines University Faculty of Science, Montigny le Bretonneux, France
- Center for Research in Epidemiology and Population Health, The French National Institute of Health and Medical Research, INSERM U1018 Equipe 11, Villejuif, Île-de-France, France
| | - Bastien Bourrion
- General Practice, Versailles Saint-Quentin-en-Yvelines University Faculty of Science, Montigny le Bretonneux, France
- Center for Research in Epidemiology and Population Health, The French National Institute of Health and Medical Research, INSERM U1018 Equipe 11, Villejuif, Île-de-France, France
| | - Dominik Menges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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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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Okazaki Y, Yoshida S, Kashima S, Ishii S, Koike S, Matsumoto M. Impact of the 2018 Japan Floods on benzodiazepine use: a longitudinal analysis based on the National Database of Health Insurance Claims. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2411-2421. [PMID: 35474395 DOI: 10.1007/s00127-022-02289-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 04/12/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Natural disaster has an impact on mental health. The 2018 Japan Floods, which took place in July 2018 were one of the largest water disasters in Japan's recorded history. We aimed to evaluate the change in the number of benzodiazepine prescriptions by physicians before and after the disaster. METHODS A retrospective cohort study based on the National Database of Health Insurance Claims was conducted in the flood-stricken areas between July 2017 and June 2019. The subjects were divided between victims and non-victims according to certification by local governments. Members of both groups were then categorized into three groups based on their pre-flood use of benzodiazepines: non-user, occasional user, and continuous user. Difference-in-differences (DID) analysis with a logistic regression model was conducted to estimate the effect of the disaster among victims by comparing the occurrence of benzodiazepine prescriptions before and after the disaster. RESULTS Of 5,000,129 people enrolled, 31,235 were victims. Among all participants, the mean prescription rate for benzodiazepines in victims before the disaster (11.3%) increased to 11.8% after the disaster, while that in non-victims (8.3%) decreased to 7.9%. The DID analysis revealed that benzodiazepine prescription among victims significantly increased immediately after the disaster (adjusted ratio of odds ratios (ROR) 1.07: 95% confidence interval 1.05-1.11), and the effect of the disaster persisted even 1 year after the disaster (adjusted ROR 1.2: 95% confidence interval 1.16-1.24). CONCLUSION The flood increased the number of benzodiazepines prescriptions among victims, and the effect persisted for at least 1 year.
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Affiliation(s)
- Yuji Okazaki
- Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.
- Department of Community-Based Medical Systems, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Shuhei Yoshida
- Department of Community-Based Medical Systems, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Saori Kashima
- Environmental Health Sciences Laboratory, Graduate School of Advanced Science and Engineering, Hiroshima University, 1-5-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8529, Japan
| | - Shinya Ishii
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Soichi Koike
- Division of Health Policy and Management, Center for Community Medicine, Jichi Medical University, 3311-1 Yakushiji, Tochigi, 329-0498, Japan
| | - Masatoshi Matsumoto
- Department of Community-Based Medical Systems, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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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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Davey CJE, Kraak MHS, Praetorius A, Ter Laak TL, van Wezel AP. Occurrence, hazard, and risk of psychopharmaceuticals and illicit drugs in European surface waters. WATER RESEARCH 2022; 222:118878. [PMID: 35878520 DOI: 10.1016/j.watres.2022.118878] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to provide insights into the risk posed by psychopharmaceuticals and illicit drugs in European surface waters, and to identify current knowledge gaps hampering this risk assessment. First, the availability and quality of data on the concentrations of psychopharmaceuticals and illicit drugs in surface waters (occurrence) and on the toxicity to aquatic organisms (hazard) were reviewed. If both occurrence and ecotoxicity data were available, risk quotients (risk) were calculated. Where abundant ecotoxicity data were available, a species sensitivity distribution (SSD) was constructed, from which the hazardous concentration for 5% of the species (HC5) was derived, allowing to derive integrated multi-species risks. A total of 702 compounds were categorised as psychopharmaceuticals and illicit drugs based on a combination of all 502 anatomical therapeutic class (ATC) 'N' pharmaceuticals and a list of illicit drugs according to the Dutch Opium Act. Of these, 343 (49%) returned occurrence data, while only 105 (15%) returned ecotoxicity data. Moreover, many ecotoxicity tests used irrelevant endpoints for neurologically active compounds, such as mortality, which may underestimate the hazard of psychopharmaceuticals. Due to data limitations, risks could only be assessed for 87 (12%) compounds, with 23 (3.3%) compounds indicating a potential risk, and several highly prescribed drugs returned neither occurrence nor ecotoxicity data. Primary bottlenecks in risk calculation included the lack of ecotoxicity data, a lack of diversity of test species and ecotoxicological end points, and large disparities between well studied and understudied compounds for both occurrence and toxicity data. This study identified which compounds merit concern, as well as the many compounds that lack the data for any calculation of risk, driving research priorities. Despite the large knowledge gaps, we concluded that the presence of a substantial part (26%) of data-rich psychopharmaceuticals in surface waters present an ecological risk for aquatic non-target organisms.
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Affiliation(s)
- Charlie J E Davey
- FAME, UvA IBED: Universiteit van Amsterdam Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, the Netherlands.
| | - Michiel H S Kraak
- FAME, UvA IBED: Universiteit van Amsterdam Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, the Netherlands
| | - Antonia Praetorius
- FAME, UvA IBED: Universiteit van Amsterdam Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, the Netherlands
| | - Thomas L Ter Laak
- FAME, UvA IBED: Universiteit van Amsterdam Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, the Netherlands; KWR Water Research Institute, Nieuwegein, the Netherlands
| | - Annemarie P van Wezel
- FAME, UvA IBED: Universiteit van Amsterdam Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, the Netherlands
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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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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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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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Beaglehole B, Bloomer C, Zhang T, Hamilton G, Boden JM, Mulder RT, Bell C, Frampton C. The impact of the Canterbury earthquakes on dispensing for older person's mental health. Int J Geriatr Psychiatry 2019; 34:1599-1604. [PMID: 31291027 DOI: 10.1002/gps.5171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/08/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate the impact of the Canterbury earthquakes on the mental health of older people by examining dispensing patterns of psychotropic medication. METHOD Dispensing data from community pharmacies for antidepressants, antipsychotics, anxiolytics, and sedative/hypnotics are routinely recorded in a national database. Longitudinal data are available for residents of the Canterbury District Health Board (DHB) (n = 67 760 at study onset) and the rest of New Zealand (n = 469 055 at study onset). We compared older age dispensing data between 2008 and 2018 for Canterbury DHB with older age dispensing data nationally in order to assess the impact of the Canterbury earthquakes on the mental health of older persons. RESULTS Older age residents of Canterbury are dispensed antidepressants, antipsychotics, and anxiolytics at higher rates than national comparators, but this finding predated the onset of the earthquakes. Short-term increases in anxiolytic and sedative/hypnotic dispensing occurred for the month following the February 2011 earthquake. No other short- or longer-term increases in dispensing of psychiatric medication were present. CONCLUSION The February 2011 Canterbury earthquake caused a short-term increase in dispensing of anxiolytics and sedative/hypnotics. No longer-term effects on dispensing were observed. This suggests that older persons sought assistance for insomnia and anxiety in the aftermath of the most devastating earthquake, but longer-term rates of clinically significant anxiety and depression for older persons did not increase as a consequence of the earthquakes sequence.
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Affiliation(s)
- Ben Beaglehole
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Christopher Bloomer
- Division of Mental Health, Canterbury District Health Board, Christchurch, New Zealand
| | - Tao Zhang
- Division of Planning and Funding, Canterbury District Health Board, Christchurch, New Zealand
| | - Greg Hamilton
- Division of Planning and Funding, Canterbury District Health Board, Christchurch, New Zealand
| | - Joseph M Boden
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Roger T Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Caroline Bell
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Chris Frampton
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
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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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Woods C, West C, Buettner P, Usher K. "Out of our control": living through Cyclone Yasi. Int J Qual Stud Health Well-being 2014; 9:19821. [PMID: 24434053 PMCID: PMC3895262 DOI: 10.3402/qhw.v9.19821] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2013] [Indexed: 11/14/2022] Open
Abstract
The aim of this study was to explore the experiences of people who lived through Cyclone Yasi on 3 February 2011. Data from two open-ended questions (Q1: n=344; and Q2: n=339) within a survey completed by 433 residents of cyclone-affected areas between Cairns and Townsville, Australia, were analysed using a qualitative, thematic approach. Experiences were portrayed in three main themes: (1) living in the mode of existential threat describes survivors' sense of panic and feeling at the mercy of nature as they feared for their life; (2) unforgettable memories describe feelings of emotional helplessness and the unimaginable chaos that the cyclone wrought; and (3) centrality of others shows how community support and closeness helped alleviate losses and uncertainty. A critical finding from this study was the negative role of the media in escalating fears for life prior to and during the cyclone, highlighting the need for government, community leaders, and health professionals to have a media plan in place to ensure that disaster warnings are taken seriously without inciting unnecessary panic. Although survivors experienced extreme vulnerability and a threat to life, the disaster also brought communities closer together and connected family, friends, and neighbours through the caring, support, and help they offered each other. This highlights the central role of others during the recovery process and underlines the importance of promoting and facilitating social support to aid recovery post disaster.
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Affiliation(s)
- Cindy Woods
- School of Nursing, Midwifery & Nutrition, James Cook University, Cairns, Australia;
| | - Caryn West
- School of Nursing, Midwifery & Nutrition, James Cook University, Cairns, Australia
| | - Petra Buettner
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia
| | - Kim Usher
- School of Nursing, Midwifery & Nutrition, James Cook University, Cairns, Australia
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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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