Gerard Anmella , Miriam Sanabra , Mireia Primé-Tous , Xavier Segú , Aleix Solanes , Victoria Ruíz , Ivette Morilla , Antonieta Also Fontanet , Elisenda Sant , Sandra Murgui , Mireia Sans-Corrales , Anabel Martínez-Aran , Giovanna Fico , Michele De Prisco , Vincenzo Oliva , Andrea Murru , Roland Zahn , Allan H. Young , Victor Vicens , Clara Viñas-Bardolet , Diego Hidalgo-Mazzei
{"title":"初级保健中抗抑郁药的过度使用：加泰罗尼亚2010年至2019年的处方趋势。","authors":"Gerard Anmella , Miriam Sanabra , Mireia Primé-Tous , Xavier Segú , Aleix Solanes , Victoria Ruíz , Ivette Morilla , Antonieta Also Fontanet , Elisenda Sant , Sandra Murgui , Mireia Sans-Corrales , Anabel Martínez-Aran , Giovanna Fico , Michele De Prisco , Vincenzo Oliva , Andrea Murru , Roland Zahn , Allan H. Young , Victor Vicens , Clara Viñas-Bardolet , Diego Hidalgo-Mazzei","doi":"10.1016/j.rpsm.2022.12.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>There has been an increase in the prescription of antidepressants (AD) in primary care (PC). However, it is unclear whether this was explained by a rise in diagnoses with an indication for AD. We investigated the changes in frequency and the variables associated with AD prescription in Catalonia, Spain.</div></div><div><h3>Methods</h3><div><span>We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (</span><em>N</em> <!-->=<!--> <!-->947.698) attending PC between 2010 and 2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription.</div></div><div><h3>Results</h3><div>Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR)<!--> <!-->=<!--> <!-->2.83), older age (IRR<!--> <!-->=<!--> <!-->25.43), and lower socio-economic status (IRR<!--> <!-->=<!--> <!-->1.35) were significantly associated with increased risk of being prescribed an AD.</div></div><div><h3>Conclusions</h3><div>Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"18 3","pages":"Pages 174-181"},"PeriodicalIF":2.8000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia\",\"authors\":\"Gerard Anmella , Miriam Sanabra , Mireia Primé-Tous , Xavier Segú , Aleix Solanes , Victoria Ruíz , Ivette Morilla , Antonieta Also Fontanet , Elisenda Sant , Sandra Murgui , Mireia Sans-Corrales , Anabel Martínez-Aran , Giovanna Fico , Michele De Prisco , Vincenzo Oliva , Andrea Murru , Roland Zahn , Allan H. Young , Victor Vicens , Clara Viñas-Bardolet , Diego Hidalgo-Mazzei\",\"doi\":\"10.1016/j.rpsm.2022.12.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>There has been an increase in the prescription of antidepressants (AD) in primary care (PC). However, it is unclear whether this was explained by a rise in diagnoses with an indication for AD. We investigated the changes in frequency and the variables associated with AD prescription in Catalonia, Spain.</div></div><div><h3>Methods</h3><div><span>We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (</span><em>N</em> <!-->=<!--> <!-->947.698) attending PC between 2010 and 2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription.</div></div><div><h3>Results</h3><div>Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR)<!--> <!-->=<!--> <!-->2.83), older age (IRR<!--> <!-->=<!--> <!-->25.43), and lower socio-economic status (IRR<!--> <!-->=<!--> <!-->1.35) were significantly associated with increased risk of being prescribed an AD.</div></div><div><h3>Conclusions</h3><div>Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.</div></div>\",\"PeriodicalId\":101179,\"journal\":{\"name\":\"Spanish Journal of Psychiatry and Mental Health\",\"volume\":\"18 3\",\"pages\":\"Pages 174-181\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spanish Journal of Psychiatry and Mental Health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1888989122001379\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"0\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spanish Journal of Psychiatry and Mental Health","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1888989122001379","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"0","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia
Introduction
There has been an increase in the prescription of antidepressants (AD) in primary care (PC). However, it is unclear whether this was explained by a rise in diagnoses with an indication for AD. We investigated the changes in frequency and the variables associated with AD prescription in Catalonia, Spain.
Methods
We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (N = 947.698) attending PC between 2010 and 2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription.
Results
Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR) = 2.83), older age (IRR = 25.43), and lower socio-economic status (IRR = 1.35) were significantly associated with increased risk of being prescribed an AD.
Conclusions
Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.
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