Seasonal variation in antidepressant prescriptions, environmental light and web queries for seasonal affective disorder

Consumption of psychotropic drugs in Croatia before and during the COVID-19 pandemic: a 10-year longitudinal study (2012-2021)

PURPOSE

This longitudinal study aimed to examine the trends in antipsychotics, antidepressants, anxiolytics, and hypnotics/sedatives consumption in Croatia over a 10-year period (2012-2021). The study also assessed whether the COVID-19 pandemic had an impact on the yearly consumption of psychotropic drugs.

METHODS

Data were collected from Croatian Agency for Medicinal Products and Medical Devices (HALMED) and presented as defined daily doses per 1000 inhabitants per day (DDD/TID). The consumption before (2012-2019) and during the COVID-19 pandemic (2020-2021) was compared with interrupted time series analysis.

RESULTS

There was an increase in total consumption of analyzed psychotropic drugs in Croatia between the years 2012 and 2021, from 115.47 DDD/TID in 2012 to 155.50 DDD/TID in 2021. An increasing trend was observed in the consumption of all 4 analyzed groups of medicines (antipsychotics, anxiolytics, hypnotics and sedatives, and antidepressants). Anxiolytics accounted for 59% (68.29/115.47 DDD/TID), and hypnotics and sedatives for 8.5% (9.76/115.47 DDD/TID) of total consumption in 2012. At the end of a 10-year period, hypnotics and sedatives represented 12% (19.05/155.50 DDD/TID) and anxiolytics 54% (83.53/155.50 DDD/TID) of psychotropic drugs consumption. The total consumption of psychotropic drugs was not significantly different before and during COVID-19 pandemic (estimate ± standard error = 5.029 ± 6.899, t = 0.729, P = 0.490).

CONCLUSION

Croatia had a high, continuously increasing consumption of psychotropic drugs. National anxiolytics consumption was one of the highest globally, while consumption of antidepressants was rather low compared to other high-income countries. The COVID-19 pandemic did not seem to influence the yearly utilization of psychotropic drugs in Croatia.

Higher Seasonal Variation of Systemic Inflammation in Bipolar Disorder

Seasonal rhythms affect the immune system. Evidence supports the involvement of immuno-inflammatory mechanisms in bipolar disorder (BD), with the neutrophil to lymphocyte ratio (NLR), and the systemic immune-inflammatory index (SII; platelets × neutrophils/lymphocytes) consistently reported to be higher in patients with BD than in HC, but seasonal rhythms of innate and adaptive immunity have never been studied. We retrospectively studied NLR and SII in 824 participants divided into three groups: 321 consecutively admitted inpatients affected by a major depressive episode in course of BD, and 255 consecutively admitted inpatients affected by obsessive-compulsive disorder (OCD; positive psychiatric control), and 248 healthy controls (HC). Patients with BD showed markedly higher markers of systemic inflammation in autumn and winter, but not in spring and summer, in respect to both HC and patients with OCD, thus suggesting a specific effect of season on inflammatory markers in BD, independent of a shared hospital setting and drug treatment. Given that systemic inflammation is emerging as a new marker and as target for treatment in depressive disorders, we suggest that seasonal rhythms should be considered for tailoring antidepressant immuno-modulatory treatments in a precision medicine approach.

Short-term impact of noise, other air pollutants and meteorological factors on emergency hospital mental health admissions in the Madrid region

BACKGROUND

A number of environmental factors, such as air pollution, noise in urbanised settings and meteorological-type variables, may give rise to important effects on human health. In recent years, many studies have confirmed the relation between various mental disorders and these factors, with a possible impact on the increase in emergency hospital admissions due to these causes. The aim of this study was to analyse the impact of a range of environmental factors on daily emergency hospital admissions due to mental disorders in the Madrid Autonomous Region (MAR), across the period 2013-2018.

METHODOLOGY

Longitudinal ecological time series study analysed by Generalised Linear Models with Poisson regression, with the dependent variable being daily Emergency Hospital Mental Health Admissions (EHMHA) in the MAR, and the independent variable being mean daily concentrations of chemical pollutants, noise levels and meteorological variables.

RESULTS

EHMHA were related statistically significantly in the short term with diurnal noise levels. Relative risks (RRs) for total admissions due to mental disorders and self-inflicted injuries, in the case of diurnal noise was RR: 1.008 95%CI (1.003 1.013). Admissions attributable to diurnal noise account for 5.5% of total admissions across the study period. There was no association between hospital admissions and chemical air pollution.

CONCLUSION

Noise is a variable that shows a statistically significant short-term association with EHMHA across all age groups in the MAR region. The results of this study may serve as a basis for drawing up public health guidelines and plans, which regard these variables as risk factors for mental disorders, especially in the case of noise, since this fundamentally depends on anthropogenic activities in highly urbanised areas with high levels of traffic density.

Biological-Activity-Based Prioritization of Antidepressants in Wastewater in England and Japan

Antidepressants are one of the most commonly prescribed pharmaceuticals. Although they have been frequently detected in aquatic environments around the globe, little is known regarding their adverse effects on humans and aquatic organisms. Recently, an in vitro monoamine transporter inhibition assay was developed to detect transporter-inhibitory activities of antidepressants in wastewater in Japan. However, it was unclear which antidepressants were responsible for transporter-inhibitory activities in wastewater. Herein, the per capita consumption of 32 antidepressants, their excretion of unchanged parent compounds, per capita water consumption, removal rate during wastewater treatment processes, and potency values from the monoamine transporter inhibition assay were used to prioritize antidepressants of concern in effluent wastewater in England and Japan. In both countries, sertraline and O-desmethylvenlafaxine had the highest contribution to inhibitory activities against the human serotonin transporter (hSERT) and zebrafish SERT (zSERT), respectively. It was found that the antidepressants inhibited the zSERT more strongly than the hSERT. The inhibitory activities found against the zSERT in wastewater in England and Japan were higher than thresholds for abnormal behavior in fish. The antidepressants prioritized in this study provide insight into launching environmental monitoring and ecotoxicological studies of antidepressants.

Symptom severity and well-being of patients with mental illness during the COVID-19 pandemic: a two-wave survey

PURPOSE OF THE ARTICLE

To examine changes in symptom severity and well-being during the coronavirus disease 2019 (COVID-19) pandemic among individuals with pre-existing mental illness.

MATERIALS AND METHODS

In February 2021, we conducted a follow-up questionnaire-based survey among adults with mental illness, who responded to a similar survey on mental health in June 2020. The participants completed the 18-item Brief Symptom Inventory (BSI-18), the five-item World Health Organization Well-Being Index (WHO-5), and 14 questions evaluating worsening or improvement in mental health using the pre-pandemic period as reference. The survey data were merged with sociodemographic and clinical data from the medical records of all invitees to the first survey, enabling analysis of attrition and weighting of the results.

RESULTS

A total of 613 of 992 (62%) invitees participated in the follow-up wave of the survey. The weighted mean WHO-5 and BSI-18 scores were 38 and 27, respectively, and did not differ statistically significantly from the first wave. Multivariate logistic regression showed that having a vocational education (skilled worker/craftsman) was positively associated with reporting deterioration in psychological well-being (OR: 2.95, 95%CI: 1.14-7.81), while being unemployed was negatively associated with reporting deterioration in psychological well-being (OR: 0.20, 95%CI: 0.07-0.56) from the first to the second survey wave. The most common reason for self-reported deterioration in mental health was loneliness (70%).

CONCLUSIONS

Approximately one year into the COVID-19 pandemic, the level of symptoms remained high, whereas the level of psychological well-being remained low among patients with mental illness.

Sleep and Organizational Behavior: Implications for Workplace Productivity and Safety

The interaction between sleep and work-related behaviors influence many aspects of employee performance, safety, and health as well as organizational-level success. Although it is well established that quantity and quality of sleep can affect different types of task performance and personal health, the interactions between sleep habits and organizational behaviors have received much less attention. It is important to examine how sleep habits and workplace behaviors relate and the role of the underlying circadian rhythm on the potential impact of sleep and sleepiness in the workplace. Developing a deeper understanding of how sleep habits and sleepiness impact workers and the organization can help provide the necessary background for human resource management to develop more progressive support networks for employees that benefit both the worker and the organization. Human resources and employees should emphasize the impact of good sleep and sleep habits on organizational and individual productivity and safety.