Self-medication with psychotropic drugs and mental health during residency. A survey of 2,314 resident physicians.

This chapter explores the unique barriers and facilitators to acceptance that men with serious mental illness may experience. The values associated with traditional masculinity are discussed as they pertain to the process of accepting mental illness. Barriers specific to men in our research studies are detailed, including avoidance of help-seeking and self-medication with substance abuse. In addition, the literature on misdiagnosis and underdiagnosis of mental health conditions among men is presented. Facilitators to the process of acceptance for men in the present research are discussed, including accessing supportive relationships and other mental health resources. Several participant case narratives are provided in order to demonstrate the impact of various masculinities on the process of acceptance. A clinical strategies list, discussion questions, activities, the “Men’s Acceptance of Mental Health Worksheet,” and an explanatory table are included at the close of the chapter.

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Use of Prescribed Psychotropics during Pregnancy: A Systematic Review of Pregnancy, Neonatal, and Childhood Outcomes

Brain Sciences ◽

10.3390/brainsci9090235 ◽

2019 ◽

Vol 9 (9) ◽

pp. 235 ◽

Cited By ~ 1

Author(s):

Creeley ◽

Denton

Keyword(s):

Public Health ◽

Mental Health ◽

Mental Illness ◽

Clinical Research ◽

Prenatal Exposure ◽

Psychotropic Drugs ◽

Health Concern ◽

Neurodevelopmental Outcomes ◽

Mother And Child

This paper reviews the findings from preclinical animal and human clinical research investigating maternal/fetal, neonatal, and child neurodevelopmental outcomes following prenatal exposure to psychotropic drugs. Evidence for the risks associated with prenatal exposure was examined, including teratogenicity, neurodevelopmental effects, neonatal toxicity, and long-term neurobehavioral consequences (i.e., behavioral teratogenicity). We conducted a comprehensive review of the recent results and conclusions of original research and reviews, respectively, which have investigated the short- and long-term impact of drugs commonly prescribed to pregnant women for psychological disorders, including mood, anxiety, and sleep disorders. Because mental illness in the mother is not a benign event, and may itself pose significant risks to both mother and child, simply discontinuing or avoiding medication use during pregnancy may not be possible. Therefore, prenatal exposure to psychotropic drugs is a major public health concern. Decisions regarding drug choice, dose, and duration should be made carefully, by balancing severity, chronicity, and co-morbidity of the mental illness, disorder, or condition against the potential risk for adverse outcomes due to drug exposure. Globally, maternal mental health problems are considered as a major public health challenge, which requires a stronger focus on mental health services that will benefit both mother and child. More preclinical and clinical research is needed in order to make well-informed decisions, understanding the risks associated with the use of psychotropic medications during pregnancy.

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Exploring the Link Between Substance Use and Mental Health Status: What Can We Learn from the Self-medication Theory?

Journal of Health Care for the Poor and Underserved ◽

10.1353/hpu.2017.0056 ◽

2017 ◽

Vol 28 (2S) ◽

pp. 113-131 ◽

Cited By ~ 12

Author(s):

L. Lerissa Smith ◽

Fengxia Yan ◽

Mikayla Charles ◽

Kamal Mohiuddin ◽

Dawn Tyus ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Health Status ◽

Mental Health Status ◽

The Self ◽

Self Medication

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“I’m Not a Traditional Woman”: Tranquilizer Misuse as Self-Medication Among Adult Women

American Behavioral Scientist ◽

10.1177/0002764218787027 ◽

2018 ◽

Vol 62 (11) ◽

pp. 1562-1585 ◽

Cited By ~ 2

Author(s):

Cindy Brooks Dollar ◽

Joshua A. Hendrix

Keyword(s):

Mental Health ◽

Drug Use ◽

General Strain Theory ◽

Emotional Health ◽

Poor Mental Health ◽

Strain Theory ◽

Adult Women ◽

Self Medication ◽

General Strain ◽

Using Data

Research consistently finds that men use all types of drugs more frequently and extensively than women. However, the misuse of prescription tranquilizers provides an exception. Recent research has found that women are more likely to misuse tranquilizers than men, yet few efforts have been made to systematically understand why this is the case and whether there are gendered factors that might help explain their misuse. Building on general strain theory and other scholarship concerning the links between psychological strain, mental–emotional health, and illicit drug use, we employed a mixed-methods design to investigate the interrelationships between gender, mental health, and tranquilizer misuse. Using data from the 2010 National Survey of Drug Use and Health, we examined tranquilizer misuse among women using various social, demographic, and health-related characteristics. Following this, we drew on nine in-depth interviews with adult women aged 21 to 69 years who reported a history of misusing tranquilizers. The quantitative data reveal that the odds of tranquilizer misuse are nearly two times higher for each unit increase on the poor mental health scale. Whereas being married increases the risk of misuse, having young children is associated with a decreased risk. Our analysis of the interview data reveals three main themes, related to tranquilizer access, reasons for misuse, and shame related to misuse. The interviews clearly uncover tranquilizer misuse as an attempt by women to manage competing demands between their work and home lives, and more specifically as a means of promoting success in both devotions. We conclude by arguing that women’s misuse of tranquilizers is a gendered behavior in response to gender-specific strains, which in turn reproduces gendering as an institution as well as in individual lives. The implications of these findings for general strain theory are also discussed.

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How did the use of psychotropic drugs change during the Great Recession in Portugal? A follow-up to the National Mental Health Survey

BMC Psychiatry ◽

10.1186/s12888-020-02620-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Manuela Silva ◽

Ana Antunes ◽

Sofia Azeredo-Lopes ◽

Graça Cardoso ◽

Miguel Xavier ◽

...

Keyword(s):

Mental Health ◽

Health Survey ◽

Great Recession ◽

Psychotropic Drugs ◽

The Great Recession ◽

Mental Health Survey ◽

National Mental Health

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Utilization of psychotropic drugs in Europe: Why is Portugal such a particular case?

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.557 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s225-s226

Author(s):

T. Alves-dos-Reis ◽

M.A. Matias

Keyword(s):

Mental Health ◽

Comparative Analysis ◽

Psychotropic Drugs ◽

Depressive Disorders ◽

European Countries ◽

World Health ◽

Sf 36 ◽

Competing Interest ◽

Relationship Of ◽

The Relationship

IntroductionPsychotropic drugs are among the most utilized medications in Europe.ObjectivesTo perform an international comparison of the utilization trends of antidepressants, anxiolytics, hypnotics and sedatives (AHS).MethodsWe used data from the Organization for Economic Cooperation and Development (OECD). We used the World Health Organization's Defined Daily Dosage (DDD) per 1000 inhabitants per day (DHD) methodology. We performed a general comparison between 14 European countries and a more detailed comparative analysis between Portugal, Italy, Spain and Germany. These countries were selected according to the following criteria: similar 12-month prevalence of mental health disorders, similar results for negative mental health (SF-36 questionnaire) and similar standardized death rates for suicide.ResultsPortugal had the highest overall utilization of antidepressants and AHS in 2011, amounting to 110.7 DHD, and the highest increase in utilization of AHS (1.8%) from 2003 and 2011. Concerning antidepressants, Portugal had the third highest utilization of these drugs in 2011 (78.3 DHD). Regarding the more detailed comparative analysis, utilization of AHS was still significantly higher in Portugal. Considering antidepressants, Portugal experienced an increasing utilization, which grew by approximately 11.4% from 2003 and 2008. From 2009 onward the utilization increased but at a slower pace.ConclusionThe very high utilization of these drugs, especially of AHS, is a worrying fact since this might indicate an inadequate treatment choice for anxiety and depressive disorders. Further research is needed to better understand the relationship of these findings with regulations concerning utilization of psychotropic drugs and compliance with best medical practices between distinct European countries.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Mental Health Policy and Psychotropic Drugs

Milbank Quarterly ◽

10.1111/j.1468-0009.2005.00347.x ◽

2005 ◽

Vol 83 (2) ◽

pp. 271-298 ◽

Cited By ~ 30

Author(s):

RICHARD G. FRANK ◽

RENA M. CONTI ◽

HOWARD H. GOLDMAN

Keyword(s):

Mental Health ◽

Health Policy ◽

Psychotropic Drugs ◽

Mental Health Policy

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Awareness on self-medications practices among dental students

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl3.3419 ◽

2020 ◽

Vol 11 (SPL3) ◽

pp. 1389-1392

Author(s):

Muralidharan ◽

Dhanraj Ganapathy ◽

Keerthi Sasanka

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Dental Students ◽

First Year ◽

Self Medication ◽

Over The Counter ◽

Antibiotic Drugs ◽

Stomach Pain ◽

Minor Ailments ◽

Antihistamine Drugs

Self-medication is indeed a practice where patients select and use drugs for either the management of auto-diagnosed physically or mental health problems. It was defined as the ingestion of drugs without consultation with a qualified doctor. The purpose of the research was to evaluate the perceptions and degree of self-medication practice amongst first-year dental students. This questionnaire-based survey was conducted among 100 first-year undergraduate dental students in Chennai. The questionnaire had 11 questions eliciting the practice of self-medication patterns among the students. The responses were recorded and . 61% of the respondents have the habit of self-medication. 43% said that they take for a headache, 21% said that for stomach pain, for fever 25% take self-medication and the rest said that they visit a doctor without taking any self-medication. 56% preferred medication, 9% preferred , 12% preferred Ayurveda and the rest 23% preferred the homemade medicines. 41% use antibiotic drugs, 47%use drugs and the rest 12% use antihistamine drugs. Around 71% said that they were aware of a drug overdose and the rest 29% said they were not aware. Self-medication was primarily used by dental students mainly for minor ailments with over the counter drugs. From the survey, we can conclude that there is a large number of students 61 % have the practice self-medication and so awareness must be created on it.

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The Microbiota-Gut-Brain Axis in Mental Health and Medication Response: Parsing Directionality and Causality

The International Journal of Neuropsychopharmacology ◽

10.1093/ijnp/pyaa088 ◽

2021 ◽

Vol 24 (3) ◽

pp. 216-220

Author(s):

Thomaz F S Bastiaanssen ◽

John F Cryan

Keyword(s):

Mental Health ◽

Side Effects ◽

Anxiety Disorders ◽

Psychotropic Drugs ◽

Gut Microbiome ◽

Alpha Diversity ◽

Mental Health Disorders ◽

Longitudinal Cohort ◽

Health Disorders

Abstract There is increasing evidence for the role of the microbiome in various mental health disorders. Moreover, there has been a growing understanding of the importance of the microbiome in mediating both the efficacy and side effects of various medications, including psychotropics. In this issue, Tomizawa and colleagues report on the effect of psychotropic drugs on the gut microbiome of 40 patients with depression and/or anxiety disorders. In their longitudinal cohort, the authors find that antipsychotics, but not anxiolytics, decrease microbiome alpha diversity. They further find that antipsychotics dosage was negatively correlated with alpha diversity in these patients. The health consequences of these microbiome alterations remain to be fully understood. In this commentary, we will discuss such findings through the lens of several recent studies on the microbiota-gut-brain axis. We also use the paper as a backdrop to discuss directionality and, by extension, causality in relation to microbiota-gut-brain-brain signaling.

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Characteristics of resident physicians accessing a specialised mental health service: a retrospective study

BMJ Open ◽

10.1136/bmjopen-2021-055184 ◽

2021 ◽

Vol 11 (12) ◽

pp. e055184

Author(s):

María Dolores Braquehais ◽

Sebastián Vargas-Cáceres ◽

Gemma Nieva ◽

Maria Fernanda Mantilla ◽

Germán Ortega ◽

...

Keyword(s):

Mental Health ◽

Mental Health Service ◽

Family Medicine ◽

Health Service ◽

Training Period ◽

Secondary Outcome ◽

Medical Council ◽

Main Diagnosis ◽

Care Programme ◽

Resident Physicians

ObjectivesLittle is known about resident physicians being treated at physician health programmes around the world despite the fact that it is a highly demanding training period. This study aims to describe the profiles of resident physicians accessing a specialised mental health service in Spain over a 20-year period and to compare them to consultant-grade physicians.DesignRetrospective observational study.SettingMedical records of the Galatea Care Programme for Sick Physicians.Participants1846 physicians registered at the Barcelona Medical Council-Association and admitted to the programme from January 1998 to December 2018.Primary and secondary outcome measuresNumber of admissions, sociodemographic and clinical variables, including medical specialty, main diagnosis and need of hospitalisation.ResultsResidents accounted for 18.1% (n=335) of the sample and admissions increased over the years. Most residents (n=311; 94.5%) and consultant-grade physicians (n=1391; 92.8%) were self-referred. The most common specialty among residents was family medicine (n=107; 31.9%), followed by internal medicine (n=18; 5.4%), paediatrics (n=14; 4.2%), psychiatry (n=13; 3.9%) and anaesthesiology (n=13; 3.9%). Residents, regardless of year of training, mainly asked for help because of adjustment (n=131; 39.1%), affective (n=77; 23%), anxiety disorders (n=40; 18.8%) and addictions (n=19; 5.7%). There were no significant differences between groups in the main diagnosis and in the variables related to need of hospitalisation. The percentage of residents accessing the programme was higher than in the reference population registered at the Barcelona Medical Council-Association (18.1% vs 7.6%; z=7.2, p<0.001) as was the percentage of family medicine residents (31.9% vs 19.6%; z=5.7, p<0.001).ConclusionsResidents are more likely than consultant-grade physicians to seek help when suffering from mental disorders. Local primary prevention actions since the beginning of their training period and having access to a well-known highly reliable programme may partly explain these findings.

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