Psychotropic drug use, emotional problems and health-related quality of life in a population based study

Author(s)

Camila Stéfani Estancial Fernandes

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2019-02-22

Examining board members

Marilisa Berti de Azevedo Barros; Karen Sarmento Costa; Maria Cecilia Goi Porto Alves; Camila Nascimento Monteiro; Noemia Urruth Leão Tavares

• Advisor: Marilisa Berti de Azevedo Barros

Abstract

The aim of this thesis was to analyze the use of psychotropic agents according to sociodemographic factors, the prevalence of mental problems and the search for health services that lead to the use of these drugs as well as the association between emotional problems and health-related quality of life (HRQoL). A population-based cross-sectional study was carried out using data from the Campinas Health Inquiry conducted in 2014/2015. The aim of the first study was to analyze differences between sexes regarding the use of psychotropic agents and associated factors as well as identify the most used drug classes. The sample in this study was composed of 1999 individuals aged 20 years or older. The prevalence of psychotropic use was 11.7% (7.3% among men and 15.8% among women). The percentage of the use of antidepressants was higher among women (44.3%) compared to men (25.5%). Reports of an emotional/mental problem were associated with the greater use of psychotropic agents in both sexes. Among the men, having a white skin color, the lack of an occupational activity, a larger number of complaints of health problems and insomnia were associated with use. Among the women, a significant increase in the use of psychotropic agents was found with the increase in age and higher prevalence rates of use were found among those with a higher level of schooling, those with a greater number of diagnosed chronic diseases and those with a common mental disorder (CMD). The second study investigated the existence of racial inequality in the prevalence of emotional/mental problems, CMD, insomnia, the search for health services and the use of psychotropic agents. The sample was composed of 1953 individuals aged 20 years or older. The central variable was self-declared skin color/race (categories: white and brown/black). The prevalence of CMD was greater among black/brown individuals. Although no difference was found in the prevalence of a reported emotional/mental problem between the racial groups, white individuals sought health services more due to this problem. Whites also used more psychotropic agents than non-whites. The aim of the third study was to analyze associations and the negative impact on HRQoL according to the type of emotional problem, degree of limitation and perception of the control of the problem through treatment. The sample was composed of 2178 individuals aged 18 years or older. The SF-36® questionnaire was used for the assessment of HRQoL. Individuals with an emotional/mental problem had lower mean scores on all domains of the SF-36®, including the physical component. A complaint of depression was more strongly associated with HRQoL than anxiety. Individuals with higher degrees of limitation caused by the problem had lower mean SF-36® scores and the negative impact on HRQoL was substantially greater among those whose problem was not controlled. In conclusion, the present results can contribute to improving public policies directed at mental health to favor the promotion of the rational and egalitarian use of psychotropic medications as well as preventive actions with the aim of reducing the impact of mental problems on HRQoL (AU)

• FAPESP's process: 15/16161-9 - Use of psychotropic drugs: associated factors, reasons for use and time trends in population-based study
• Grantee: Camila Stéfani Estancial Fernandes
• Support Opportunities: Scholarships in Brazil - Doctorate