Epidemiology of psychotropic drug use in Rio de Janeiro, Brazil: gaps in mental illness treatments

• Published in: PloS one 2013-05, Vol.8 (5), p.e62270-e62270
• Main Authors: Quintana, Maria Ines, Andreoli, Sergio B, Moreira, Fernanda G, Ribeiro, Wagner S, Feijo, Marcelo M, Bressan, Rodrigo A, Coutinho, Evandro S F, Mari, Jair J
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Alcoholism; Analysis; Antidepressants; Anxiety; Brazil - epidemiology; Cities - epidemiology; Confidence intervals; Data Collection; Diagnosis; Diagnostic systems; Drug abuse; Drug Prescriptions - statistics & numerical data; Drug use; Drugs; Epidemiology; Female; Females; Genetics; Humans; Male; Medical diagnosis; Medical personnel; Medicine; Mental depression; Mental disorders; Mental Disorders - drug therapy; Mental Disorders - epidemiology; Mentally ill persons; Middle Aged; Mood; Post traumatic stress disorder; Posttraumatic stress disorder; Probabilistic methods; Psychotropic drugs; Psychotropic Drugs - therapeutic use; Regression analysis; Regression models; Statistical analysis; Studies; Tranquilizers; Tranquilizing agents; Workers; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0062270

Estimate the prevalence of psychotropic drugs use in the city of Rio de Janeiro, Brazil, and establish its relationship with the presence of mental disorders. A probabilistic sample of non-institutionalized individuals, from the general population of Rio de Janeiro (n = 1208;turn out:81%), 15 years or older, who were interviewed using the Composite International Diagnostic Interview 2.1 (depression, anxiety-phobia, OCD\PTSD, alcoholism sections), and asked about their psychotropic use during a 12 and one-month period before the interview. Data were collected between June/2007-February/2008.The prevalence was estimated with a confidence interval of 95%. The associations between psychotropics use and mental disorders were analyzed through a logistic regression model (Odds Ration - OR). The one-month prevalence of psychotropic drug use was 6.55%, 3.19% for men and 9.13% for women. Antidepressants were the most frequently used drug (2.78%), followed by anorectics (1.65%), tranquilizers (1.61%) and mood stabilizers (1.23%). General practitioners issued the highest number of prescriptions (46.3%), followed by psychiatrists (29.3%); 86.6% of the psychotropic drugs used were paid for by the patient himself. Individuals with increased likelihood of using psychotropic drugs were those that had received a psychiatric diagnosis during a one-month period before the study (OR:3.93), females (OR:1.82), separated/divorced (OR:2.23), of increased age (OR:1.03), with higher income (OR:2.96), and family history of mental disorder (OR:2.59); only 16% of the individuals with a current DSM IV diagnosis were using a psychotropic drug; 17% among individuals with a depression-related diagnosis and 8% with Phobic Anxiety Disorders-related diagnosis used psychotropics. Approximately 84% of individuals displaying some mental disorder did not use psychotropic drugs, which indicates an important gap between demand and access to treatment. A significant failure is evident in the health system for patients with mental disorders; this could be due to health workers' inability to recognize mental disorders among individuals.