Use of psychotropic medication in the general population of France, Germany, Italy, and the United Kingdom

J Clin Psychiatry. 2002 Sep;63(9):817-25. doi: 10.4088/jcp.v63n0912.

Abstract

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Anxiety Agents / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Comorbidity
  • Cross-Cultural Comparison*
  • Drug Utilization
  • Expert Systems
  • Female
  • France / epidemiology
  • Germany / epidemiology
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Italy / epidemiology
  • Logistic Models
  • Male
  • Mental Disorders / drug therapy
  • Mental Disorders / epidemiology
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data
  • Psychotropic Drugs / administration & dosage
  • Psychotropic Drugs / therapeutic use*
  • Sleep Wake Disorders / drug therapy
  • Sleep Wake Disorders / epidemiology
  • United Kingdom / epidemiology

Substances

  • Anti-Anxiety Agents
  • Antidepressive Agents
  • Hypnotics and Sedatives
  • Psychotropic Drugs