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Use of Psychotropic Medication in the General Population of France, Germany, Italy, and the United Kingdom.
Background: The use of psychotropic medications and its association with sleep and psychiatric and physical illnesses were studied in the general population.
Method: A cross-sectional telephone survey was carried out using the Sleep-EVAL knowledge-base system. A representative sample of the noninstitutionalized general populations of France, Germany, Italy, and the United Kingdom, aged 15 years or over, was interviewed (N=18,679; participation rate: 78.8%; target population: 204,605,391 inhabitants). Questions were asked about psychotropic medication intake (name of medication, indication, dosage, duration of intake, prescriber), sociodemographics, physical illnesses, and DSM-IV mental disorders.
Results: At the time of the interview, 6.4% of
the subjects took a psychotropic medication.
Anxiolytics were reported by 4.3% of the sample, hypnotics
by 1.5%, antidepressants by 1.0%, and neuroleptics
and other psychotropics by less than 1.0%.
Hypnotics and anxiolytics were mostly used as a sleep
disorder treatment. Antidepressants were taken
appropriately for a depressive illness in only 44.1% of cases.
Low doses of hypnotics and anxiolytics were found
in about 10% of cases and low doses of
antidepressants in 31.7% of cases. Subjects with a psychiatric
disorder received a psychotropic treatment only
infrequently (between 10% to 40.4%, depending on
the disorder). All psychiatric disorders, including
mood disorders, were treated mainly with an anxiolytic.
A concomitant physical illness increased the likelihood of using a psychotropic treatment and was
a strong predictor of adequate psychotropic dosage.
Conclusion: Psychiatric pathology and
sleep disorders remained mostly untreated or
inadequately managed in the general population. Depression
is underdiagnosed by the physicians and is treated
with antidepressant in only 7% of cases. By contrast, anxiolytics are extensively prescribed, especially in France and Italy. The co-occurrence of organic and psychiatry disorders increases the frequency of medical consultations and the likelihood of being given a prescription for the mental disorder.