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Miranda ES, Dell'Aringa M, Costa EAD, Piazza T, Corte FD, Ragazzoni L, Barone-Adesi F, Andrade CLTD, Osorio-de-Castro CGS. Psychoactive substance consumption after the Fundão dam mine tailing disaster in Minas Gerais State, Brazil. CAD SAUDE PUBLICA 2024; 40:e00237022. [PMID: 38477725 DOI: 10.1590/0102-311xen237022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 12/04/2023] [Indexed: 03/14/2024] Open
Abstract
Disasters cause changes in morbidity, mortality, and medicine use. Brazil is one of the main producers of mineral ores at great environmental cost. Mine tailings are stored in dams and ruptures have led to major disasters. We investigated the consumption of psychoactive medicines in the municipalities affected by the Fundão dam disaster in Minas Gerais State. An ecological study was carried out on drug consumption, estimated using public purchases in Minas Gerais and dispensing data from private retail pharmacies. Consumption (in number of defined daily doses/100,000 inhabitants per day) was analyzed descriptively in eight municipalities, stratified according to consumption level during a 25-month period. Six comparisons of mean consumption values for both data sets were done for pre- and post-disaster periods. The means of medicine consumption before and after the event were plotted and linear trends were added. Public purchase data evinced high consumption levels. Only pharmaceutical retail showed significant differences between the strata in the pre-disaster versus two post-disaster periods. Smaller municipalities showed an increase in consumption 15 months after the disaster. Clonazepam led the way in pharmaceutical retail consumption, followed by fluoxetine. Medicines showed an upward trend after the disaster. The high public provision may have stifled significant consumption patterns of psychoactive drugs; however, peak consumption were observed in private retail, suggesting a modification in use patterns after the disaster. The decrease in consumption immediately after the event was probably related to lower care-seeking behavior on the part of the population, and significant peaks after the disaster may reflect economic consequences of it.
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Affiliation(s)
| | - Marcelo Dell'Aringa
- Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | | | - Thais Piazza
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Francesco Della Corte
- Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Luca Ragazzoni
- Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Francesco Barone-Adesi
- Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
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Myran D, Milani C, Pugliese M, Hensel JM, Sood M, Kendall CE, Kendzerska T, Tanuseputro P. Physician benzodiazepine self-use prior to and during the COVID-19 pandemic in Ontario, Canada: a population-level cohort study. BMJ Open 2023; 13:e062742. [PMID: 37085307 PMCID: PMC10123848 DOI: 10.1136/bmjopen-2022-062742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVES The aim of this study was to investigate physician benzodiazepine (BZD) self-use pre-COVID-19 pandemic and to examine changes in BZD self-use during the first year of the pandemic. DESIGN Population-based retrospective cohort study using linked routinely collected administrative health data comparing the first year of the pandemic to the period before the pandemic. SETTING Province of Ontario, Canada between March 2016 and March 2021. PARTICIPANTS INTERVENTION: Onset of the COVID-19 pandemic in March 2020. OUTCOMES MEASURES The primary outcome measure was the receipt of one or more prescriptions for BZD, which was captured via the Narcotics Monitoring System. RESULTS In a cohort of 30 798 physicians (mean age 42, 47.8% women), we found that during the year before the pandemic, 4.4% of physicians had 1 or more BZD prescriptions. Older physicians (6.8% aged 50+ years), female physicians (5.1%) and physicians with a prior mental health (MH) diagnosis (12.4%) were more likely than younger (3.7% aged <50 years), male physicians (3.8%) and physicians without a prior MH diagnosis (2.9%) to have received 1 or more BZD prescriptions. The first year of the COVID-19 pandemic was associated with a 10.5% decrease (adjusted OR (aOR) 0.85, 95% CI: 0.80 to 0.91) in the number of physicians with 1 or more BZD prescriptions compared with the year before the pandemic. Female physicians were less likely to reduce BZD self-use (aORfemale=0.90, 95% CI: 0.83 to 0.98) compared with male physicians (aORmale=0.79, 95% CI: 0.72 to 0.87, pinteraction=0.046 during the pandemic. Physicians presenting with an incident MH visit had higher odds of filling a BZD prescription during COVID-19 compared with the prior year. CONCLUSIONS Physicians' BZD prescriptions decreased during the first year of the COVID-19 pandemic in Ontario, Canada. These findings suggest that previously reported increases in mental distress and MH visits among physicians during the pandemic did not lead to greater self-use of BZDs.
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Affiliation(s)
- Daniel Myran
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Bruyere Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | - Christina Milani
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
| | - Michael Pugliese
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | | | - Manish Sood
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Claire E Kendall
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Tetyana Kendzerska
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
- Respirology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
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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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Disaster Preparedness: Hospital Pharmacy Strategy for Prioritized Inventory Management and Drug Procurement on Vancouver Island. Disaster Med Public Health Prep 2022; 17:e235. [PMID: 36047249 DOI: 10.1017/dmp.2022.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Disaster events can increase demand for medication supplies and interfere with supply chains, leading to compromised care in hospitals. Providing an organized response to an additional surge of disaster-related patients requires pre-planned emergency management procedures. Hospital pharmacists can address this with prioritized drug procurement and inventory management strategies which may improve the availability of key medications for a disaster response. Previous disaster events have provided insight on medications used to treat disaster-related injuries and exacerbations of medical conditions in emergency departments. This article provides a detailed description of Vancouver Island's hospital pharmacy strategy for the procurement and minimum stock levels of high priority medications in preparation for a disaster.
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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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Beaglehole B, Mulder RT, Boden JM, Bell CJ. A systematic review of the psychological impacts of the Canterbury earthquakes on mental health. Aust N Z J Public Health 2019; 43:274-280. [PMID: 30958618 DOI: 10.1111/1753-6405.12894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/01/2018] [Accepted: 02/01/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This systematic review aims to identify and evaluate all studies that measured psychological distress or mental disorder following the Canterbury earthquakes to establish the psychological consequences of the earthquakes on those exposed. A secondary aim is to outline and emphasise key methodological factors in disaster research. METHOD Eligible studies were identified following a comprehensive literature search. A quality assessment was undertaken for all included studies. This was followed by methodological and descriptive review. RESULTS Thirty-one papers measuring psychological distress or mental disorder following the Canterbury earthquakes were identified. These papers reported outcomes from 20 separate studies of which seven were rated high-quality, eight were rated medium and five were rated low-quality. Key methodological findings and outcomes are discussed for each study. CONCLUSION The Canterbury earthquakes were associated with widespread but not universal adverse effects on mental health. Disaster research quality is assisted by representative samples, repeated measures, and the use of appropriate controls to allow accurate assessments of psychological consequences to be made. Implications for public health: The presence of widespread adverse effects as a result of the earthquakes suggests broad-ranging community initiatives are essential to mitigate the negative consequences of disasters.
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Affiliation(s)
- Ben Beaglehole
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Roger T Mulder
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Joseph M Boden
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Caroline J Bell
- Department of Psychological Medicine, University of Otago, New Zealand
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Allen J, Brown LM, Alpass FM, Stephens CV. Longitudinal health and disaster impact in older New Zealand adults in the 2010-2011 Canterbury earthquake series. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:701-718. [PMID: 29989482 DOI: 10.1080/01634372.2018.1494073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Pre-existing longitudinal studies of people affected by disasters provide opportunities to examine the effects of these events on health. Data used in the current investigation were provided by participants in the New Zealand Health, Work and Retirement longitudinal surveys conducted in 2010, 2012 and 2014 (n = 428; aged 50-83), who lived in the Canterbury region of New Zealand during the 2010-2011 earthquakes. Latent profile growth analyses were used to identify groups of respondents who had similar pre-post-disaster physical and mental health profiles. These groups were compared in terms of demographic factors, personal impact of the earthquakes assessed in 2012 and the overall negative-positive impact of the earthquake assessed in 2014. There was little evidence of change in health status overtime. Groups did not differ in their experiences of threat or disruption, however those in poorest health reported greatest distress and a more negative overall impact of the earthquake. Although results suggest little impact of disasters on health of surviving older adults, pre-disaster vulnerabilities were associated with distress. Social workers and agencies responsible for disaster response can play a key role in pre-disaster planning and assessment of vulnerabilities of older adults to enhance potential for positive outcomes post-disaster.
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Affiliation(s)
- Joanne Allen
- a School of Psychology , Massey University , Palmerston North , New Zealand
| | - Lisa M Brown
- b Trauma Program , Palo Alto University , Palo Alto , California , USA
| | - Fiona M Alpass
- a School of Psychology , Massey University , Palmerston North , New Zealand
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Beaglehole B, Frampton CM, Boden JM, Mulder RT, Bell CJ. An evaluation of Health of the Nation Outcome Scales data to inform psychiatric morbidity following the Canterbury earthquakes. Aust N Z J Psychiatry 2017. [PMID: 28639479 DOI: 10.1177/0004867417714879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Following the onset of the Canterbury, New Zealand earthquakes, there were widespread concerns that mental health services were under severe strain as a result of adverse consequences on mental health. We therefore examined Health of the Nation Outcome Scales data to see whether this could inform our understanding of the impact of the Canterbury earthquakes on patients attending local specialist mental health services. METHOD Health of the Nation Outcome Scales admission data were analysed for Canterbury mental health services prior to and following the Canterbury earthquakes. These findings were compared to Health of the Nation Outcome Scales admission data from seven other large District Health Boards to delineate local from national trends. Percentage changes in admission numbers were also calculated before and after the earthquakes for Canterbury and the seven other large district health boards. RESULTS Admission Health of the Nation Outcome Scales scores in Canterbury increased after the earthquakes for adult inpatient and community services, old age inpatient and community services, and Child and Adolescent inpatient services compared to the seven other large district health boards. Admission Health of the Nation Outcome Scales scores for Child and Adolescent community services did not change significantly, while admission Health of the Nation Outcome Scales scores for Alcohol and Drug services in Canterbury fell compared to other large district health boards. Subscale analysis showed that the majority of Health of the Nation Outcome Scales subscales contributed to the overall increases found. Percentage changes in admission numbers for the Canterbury District Health Board and the seven other large district health boards before and after the earthquakes were largely comparable with the exception of admissions to inpatient services for the group aged 4-17 years which showed a large increase. CONCLUSION The Canterbury earthquakes were followed by an increase in Health of the Nation Outcome Scales scores for attendees of local mental health services compared to other large district health boards. This suggests that patients presented with greater degrees of psychiatric distress, social disruption, behavioural change and impairment as a result of the earthquakes.
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Affiliation(s)
- Ben Beaglehole
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Chris M Frampton
- Department of Psychological Medicine, University of Otago, Christchurch, 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 J Bell
- 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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Beaglehole B, Bell C, Frampton C, Moor S. The impact of the Canterbury earthquakes on successful school leaving for adolescents. Aust N Z J Public Health 2016; 41:70-73. [PMID: 27960250 DOI: 10.1111/1753-6405.12625] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 06/01/2016] [Accepted: 09/01/2016] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To examine the impact of the Canterbury earthquakes on the important adolescent transition period of school leaving. METHOD Local and national data on school leaving age, attainment of National Certificate of Educational Achievement (NCEA) standards, and school rolls (total registered students for schools) were examined to clarify long-term trends and delineate these from any impacts of the Canterbury earthquakes. Results: Despite concerns about negative impacts, there was no evidence for increased school disengagement or poorer academic performance by students as a consequence of the earthquakes. CONCLUSION Although there may have been negative effects for a minority, the possibility of post-disaster growth and resilience being the norm for the majority meant that negative effects on school leaving were not observed following the earthquakes. A range of post-disaster responses may have mitigated adverse effects on the adolescent population. Implications for Public Health: Overall long-term negative effects are unlikely for the affected adolescent population. The results also indicate that similar populations exposed to disasters in other settings are likely to do well in the presence of a comprehensive post-disaster response.
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Affiliation(s)
- Ben Beaglehole
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Caroline Bell
- Department of Psychological Medicine, University of Otago, New Zealand
| | | | - Stephanie Moor
- Department of Psychological Medicine, University of Otago, New Zealand
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Access to Essential Medications During Disaster Events. Prehosp Disaster Med 2016; 31:579-580. [PMID: 27667200 DOI: 10.1017/s1049023x16001035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hogg D, Kingham S, Wilson TM, Ardagh M. The effects of spatially varying earthquake impacts on mood and anxiety symptom treatments among long-term Christchurch residents following the 2010/11 Canterbury earthquakes, New Zealand. Health Place 2016; 41:78-88. [PMID: 27583524 DOI: 10.1016/j.healthplace.2016.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 01/24/2023]
Abstract
This study investigates the effects of disruptions to different community environments, community resilience and cumulated felt earthquake intensities on yearly mood and anxiety symptom treatments from the New Zealand Ministry of Health's administrative databases between September 2009 and August 2012. The sample includes 172,284 long-term residents from different Christchurch communities. Living in a better physical environment was associated with lower mood and anxiety treatment rates after the beginning of the Canterbury earthquake sequence whereas an inverse effect could be found for social community environment and community resilience. These results may be confounded by pre-existing patterns, as well as intensified treatment-seeking behaviour and intervention programmes in severely affected areas. Nevertheless, the findings indicate that adverse mental health outcomes can be found in communities with worse physical but stronger social environments or community resilience post-disaster. Also, they do not necessarily follow felt intensities since cumulative earthquake intensity did not show a significant effect.
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Affiliation(s)
- Daniel Hogg
- GeoHealth Laboratory, Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Cooperative Research Centre for Spatial Information (CRCSI), Carlton, Victoria 3053, Australia.
| | - Simon Kingham
- GeoHealth Laboratory, Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; Cooperative Research Centre for Spatial Information (CRCSI), Carlton, Victoria 3053, Australia.
| | - Thomas M Wilson
- Department of Geological Sciences, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand; The Natural Hazards Research Platform (NHRP), New Zealand.
| | - Michael Ardagh
- University of Otago, PO Box 4345, Christchurch, New Zealand; Canterbury District Health Board (CDHB), New Zealand.
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Abstract
BACKGROUND A population-based study of inflammatory bowel disease (IBD) in the Canterbury province of New Zealand demonstrated an incidence of Crohn's disease (CD) of 16.5 per 100,000 population in 2004, along with a high rate of IBD overall. At the time, this was one of the highest rates of CD in the world. The current study aimed to ascertain the incidence of IBD in the same area 10 years later. METHODS All patients diagnosed with IBD in 2014 within the Canterbury region were identified and characterized. Diagnosis and disease classification were ascertained using standard accepted criteria. Projected population data for age and gender were used to calculate incidence rates for IBD overall and for CD, ulcerative colitis (UC), and inflammatory bowel disease-unclassified (IBDU). RESULTS During the 2014 years, 205 patients were diagnosed with IBD in Canterbury. This group comprised 134 patients with CD, 69 with UC, and 2 with IBDU. The age-standardized incidence of IBD, CD, UC, and IBDU was 39.5, 26.4, 12.6, and 0.17 per 100,000, respectively. Disease location of CD patients was evenly distributed (ileal 29%, colonic 35%, and ileocolonic 32%). Similarly, patients with UC had even distribution of proctitis, left-sided, and extensive disease. CONCLUSIONS This study demonstrates a substantial increase in the incidence of IBD in this geographically well-defined area. Overall, incidence rates were 1.6-fold greater than when assessed 10 years earlier. The reasons contributing to these continued increases remain unclear. However, further increases in rates of IBD indicate growing health system demands in the future.
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