Screening for mental disorders in the community 1984 and 2002 and prescriptions for psychopharmaca in 1984 and 2001

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenBACKGROUND: During the past 15 years the use of psycho-tropic medication has increased markedly. The question addressed in this paper is whether this increase is related to change in prevalence of psychiatric disorders or symptoms. MATERIAL AND METHODS: Two data sets were used. Data from a screening of the population aged 20 to 59 years in 1984 using GHQ- 30 and prescriptions for pychotropic medications filled during March that year for outpatients in Reykjavík. Secondly, data from a population screening in January 2002 using GHQ- 12 for the same age range, and all psychotropic prescriptions filled by outpatients in 2001. RESAULTS: The prevalence of those without complaints did not change. It remained about 60%. Using a cut off 4/3 for GHQ-30 and 3/2 for GHQ-12 the prevalence rates were 16.1 % and 17.5%, respectively. By assuming that symptom-free drug users would have reached the cut-off level the prevalence increased to 20.7% Using a cut off score of 3/2 and 2/1, respectively, the prevalence for men in both years was around 18 % while that for women increased from 20.5% to 29.4% (p<0.05). In both years the prevalence was highest in the youngest age group and lowest in the oldest. Psychotropic presciptions other than hypnotics doubled. Proportionally the increase was similar for men and women, but more marked among the younger age groups. The increase in prescriptions filled for all psychotropics was 56% compared to 47% increase in the sale of all medications. CONCLUSION: Increase in the use of psychotropics is explained to a limited extent only by possibly higher prevalence of psychiatric disorders. The use of psychotropics has increased along with that of other medications, but at slightly higher pace, which may reflect the results of awareness campaigns among physicians and the general public and more effective and better tolerated medications.Tilgangur rannsóknarinnar er að athuga hvort skýringa á aukinni geðlyfjanotkun sé að leita í auknu algengi geðraskana eða einkenna sem benda til þeirra. Efniviður og aðferðir: Gögn voru fengin úr skimleit 1984 með GHQ-30 og úr rannsókn á geðlyfjaávísunum utan sjúkrahúsa í Reykjavík í mars sama ár. Til samanburðar voru fengin gögn úr skimleit með GHQ-12 sem gerð var í ársbyrjun 2002 og geðlyfja­ávísanir sem innleystar voru í apótekum 2001. Niðurstöður: Hlutfall fólks sem hafði engar kvartanir breyttist ekki, hélst um 60%. Þó jókst nokkuð hlutfall karla sem höfðu engar kvartanir, en minnkaði ómarktækt meðal kvenna. Geðraskanir eru mjög líklegar hjá þeim sem höfðu fjórar eða fleiri kvartanir samkvæmt fyrri skimleitinni og þrjár eða fleiri kvartanir samkvæmt þeirri seinni. Algengi geðraskana breyttist ekki marktækt, úr 16,1% í 17,5% miðað við þessa skilgreiningu. Ef þeim sem ekki náðu greiningarmörkum 2002 en tóku geðlyf allt árið er bætt við hækkaði algengið marktækt í 20,7%. Ef skilgreiningunni fyrir geðröskun er breytt með því að fækka kvörtunum um eina bæði árin hélst algengið óbreytt um 18% meðal karla en jókst úr 20,5% í 29,4% meðal kvenna (p