psychotropic drug use
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Author(s):  
Christine Leong ◽  
Laurence Y. Katz ◽  
James M. Bolton ◽  
Murray W. Enns ◽  
Joseph Delaney ◽  
...  

2021 ◽  
pp. 1-10
Author(s):  
Mattias Jonson ◽  
Robert Sigström ◽  
Khedidja Hedna ◽  
Therese Rydberg Sterner ◽  
Hanna Falk Erhag ◽  
...  

Abstract Background Octogenarians of today are better educated, and physically and cognitively healthier, than earlier born cohorts. Less is known about time trends in mental health in this age group. We aimed to study time trends in the prevalence of depression and psychotropic drug use among Swedish 85-year-olds. Methods We derived data from interviews with 85-year-olds in 1986–1987 (N = 348), 2008–2010 (N = 433) and 2015–17 (N = 321). Depression diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders. Symptom burden was assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS). Information on psychotropic drug use, sociodemographic, and health-related factors were collected during the interviews. Results The prevalence of major depression was lower in 2015–2017 (4.7%, p < 0.001) and 2008–2010 (6.9%, p = 0.010) compared to 1986–1987 (12.4%). The prevalence of minor depression was lower in 2015–2017 (8.1%) compared to 2008–2010 (16.2%, p = 0.001) and 1986–1987 (17.8%, p < 0.001). Mean MADRS score decreased from 8.0 in 1986–1987 to 6.5 in 2008–2010, and 5.1 in 2015–2017 (p < 0.001). The reduced prevalence of depression was not explained by changes in sociodemographic and health-related risk factors for depression. While psychoactive drug use was observed in a third of the participants in each cohort, drug type changed over time (increased use of antidepressants and decreased use of anxiolytics and antipsychotics). Conclusions The prevalence of depression in octogenarians has declined during the past decades. The decline was not explained by changes in known risk factors for depression. The present study cannot answer whether changed prescription patterns of psychoactive drugs have contributed to the decline.


2021 ◽  
Vol 12 ◽  
Author(s):  
Ivana Bojanić ◽  
Erik R. Sund ◽  
Ottar Bjerkeset ◽  
Børge Sivertsen ◽  
Hege Sletvold

Background: Students pursuing higher education are struggling with psychological distress, which in turn may negatively affect their academic self-efficacy and study progress. Although psychotropic drug use is widespread and increasing, patterns of psychotropic drug use among students are not well-known.Aim: To describe prevalence and gender differences in psychotropic drug use among Norwegian students in higher education, and to examine associations with level of psychological distress.Methods: The study is based on data from the Norwegian Student's Health and Well-being Study (SHoT), 2018, a national survey including all fulltime students aged 18–35 years in higher education. Our sample included 49,836 students, 69% females. Use of psychotropic drugs and psychological distress (The Hopkins Symptoms Checklist [HSCL-25]) were self-reported. Generalised linear models were used to assess associations between psychological distress and psychotropic drug use.Results: Psychotropic drug use was more frequent among female than male students: 4 vs. 2% daily antidepressants usage; 5 vs. 3% last month use of anxiolytics/tranquillisers; and 8 vs. 5% last month use of hypnotics. In contrast, male students reported use of performance enhancing drugs more often than females (7 vs. 5%). Adjusted associations between high level of psychological distress (HSCL-25 ≥ 2.0) and use of psychotropics, showed an about 2-fold increased relative risk, largely consequent across drug classes and genders.Conclusion: Prevalence and gender patterns of intake of the most common psychotropic drug classes among Norwegian students are comparable to previous studies. Unexpectedly, among students with moderate to severe psychological distress, the patterns of psychotropic drug use were more or less identical between genders.


Author(s):  
Shivani R. Khan ◽  
Debra A. Heller ◽  
Leroy L. Latty ◽  
Michelle LaSure ◽  
Theresa V. Brown

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Claudia M. Groot Kormelinck ◽  
Charlotte F. van Teunenbroek ◽  
Sytse U. Zuidema ◽  
Martin Smalbrugge ◽  
Debby L. Gerritsen

Abstract Background Research suggests that collaborative and tailored approaches with external expertise are important to process implementations. We therefore performed a process evaluation of an intervention using participatory action research, tailored information provision, and external coaching to reduce inappropriate psychotropic drug use among nursing home residents with dementia. The process evaluation was conducted alongside a randomized controlled trial assessing the utility of this approach. Methods We used Leontjevas’ model of process evaluation to guide data collection and analysis, focusing on the relevance and feasibility, extent of performance, and barriers and facilitators to implementation. Data on the relevance and feasibility and on the extent of performance were collected using a questionnaire targeting internal project leaders at nursing homes and our external coaches. Implementation barriers and facilitators were identified by individual semi-structured interviews. The Consolidated Framework for Implementation Research was used to structure and describe the identified barriers and facilitators. Results The intervention was viewed positively, but it was also considered time consuming due to the involvement of many people and designing a tailored action and implementation plan was viewed as complex. The extent of performance differed between nursing homes. Delays in implementation and suboptimal execution of actions may have reduced effectiveness of the RID intervention in some nursing homes. Barriers to implementation were reorganizations, staff turnover, communication issues, unclear expectations, and perceived time pressures. Implementation also depended on the involvement and skills of key stakeholders, and organizations’ readiness to change. Although external coaches stimulated implementation, their additional value was rated variably across organizations. Conclusions Barriers to implementation occurred on several levels and some barriers appear to be inherent to the nursing home environment and could be points of leverage of future implementation trajectories. This underlines the importance of assessing and supporting organizations in their readiness to change. Sensitivity analyses, taking into account the week in which nursing homes started with implementation and the degree to which actions were implemented as intended, will be appropriate in the effect analyses of the trial.


Author(s):  
Miriam Kristine Sandvik ◽  
Leiv Otto Watne ◽  
Anniken Brugård ◽  
Marte Sofie Wang-Hansen ◽  
Hege Kersten

Abstract Purpose Handgrip strength is an indicator of frailty and longevity in older adults. The association between psychotropic drug use and handgrip strength in older hospitalized patients was investigated in this study. Methods A total of 488 patients were included in this retrospective cross-sectional study, 333 women and 155 men, from two different cohorts of older (mean age 84 years) hospitalized in-patients. We used multiple linear regression models to explore the association between psychotropic drug use and handgrip strength. We adjusted for factors known to affect handgrip strength: Age, gender, body mass index (BMI) and comorbidity (Charlson comorbidity index). Results Both unadjusted and adjusted analyses showed that psychotropic drug use was associated with handgrip strength (β = − 0.183, p < 0.0001). The relationship was of a linear character, with no clear threshold value, but with the greatest reduction in handgrip strength between zero and two psychotropic drugs. Conclusion An increasing number of psychotropic drugs were significantly associated with reduced handgrip strength in a linearly pattern. Hence, it is timely to question the guided threshold value of avoidance of three or more psychotropic drugs in older people. Psychotropic drug use should be kept as low as possible in treatment of older patients.


2021 ◽  
Vol 74 (6) ◽  
Author(s):  
Luciane Prado Kantorski ◽  
Carlos Alberto dos Santos Treichel ◽  
Cátia Gentile dos Santos ◽  
Etiene Silveira de Menezes ◽  
Mariana Dias de Almeida ◽  
...  

ABSTRACT Objectives: to identify the prevalence of psychotropic drug use according to their Anatomical Therapeutic Chemical classification among Psychosocial Care Center users and assess their prescription compliance based on the recommended therapeutic dose. Methods: this is an analytical study, based on documents, from the study of 389 records between September 2017 and May 2018. Associations between the presence of underdose or overdose and participants’ characteristics were assessed using the chi-square test, adopting a significant value of p <0.05. Results: the most used drugs were antipsychotics (74.7%), 16.0% of users with at least one medication with a dose below the therapeutic level and another 3.6% above the recommended therapeutic dose. Conclusions: greater nonconformities in the prescribed dose were related to antihistamines, antipsychotics and antidepressants, with underdosage associated with females and overdose with the report of hearing voices.


2020 ◽  
Author(s):  
Kei Fujita ◽  
Tomomi Kotani ◽  
Yoshinori Moriyama ◽  
Takafumi Ushida ◽  
Kenji Imai ◽  
...  

Abstract Background: Mental illness commonly occurs in reproductive age, and its adverse effects on mothers and children are a major public health concern. However, the extent to which the perinatal mental health care system in Japan is functioning adequately remains unexplored. This study aimed to identify the issues that exist within the perinatal mental health care system in Japan. Methods: A cross-sectional survey was conducted across medical facilities in Aichi prefecture in central Japan. Questionnaires were mailed to the head physicians of all 128 maternity care units, 21 neonatal intensive care units (NICUs), and 40 assisted reproductive technology (ART) units. The following data were collected: the number of admissions to mental health care units and admissions of neonates born to mothers with mental illness during the perinatal period between 2016 and 2018. Perspectives on psychotropic drug use during pregnancy were compared across different types of maternity care units, including maternal-fetal (MF) centers and private clinics by Fisher’s exact test. The multidisciplinary team system was also compared across different types of maternity care units by Fisher’s exact test. Results: The number of admissions to mental health care units was 82 (52.8 per 10 000 births), and 158 (1.0 per 1000 births) neonates born to mothers with mental illness were admitted to NICUs during the aforementioned period. With regard to the multidisciplinary team system, 84 (71.1 %) and 76 (64.4 %) maternity care units did not have any psychiatrists or social workers. Moreover, only 5 % of the head physicians in MF centers endorsed the discontinuation of psychotropic drug use during pregnancy. The corresponding figures were 20–35 % among those in general hospitals, private clinics, and ART units. Conclusions: Multidisciplinary system resources were perceived to be limited. Perspectives on psychotropic drug use during pregnancy differed significantly based on the type of units in which the doctors were working. There is a need for resources that will facilitate the admission of perinatal women with mental illnesses to mental health care units in Japan.


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