Antidepressant utilization in Canada
- 353 Downloads
Antidepressant utilization can be used as an indicator of appropriate treatment for major depression. The objective of this study was to characterize antidepressant utilization in Canada, including the relationships of antidepressant use with sociodemographic variables, past-year and lifetime depression, number of past depressive episodes, and other possible indications for antidepressants.
We examined data from the Canadian Community Health Survey (CCHS) Cycle 1.2. The CCHS was a nationally representative mental health survey (N=36,984) conducted in 2002 that included a diagnostic instrument for past-year and lifetime major depressive episodes and other psychiatric disorders and a record of past-year antidepressant use.
Overall, 5.8% of Canadians were taking antidepressants, higher than the annual prevalence of major depressive episode (4.8%) in the survey. Among persons with a past-year major depressive episode, the frequency of antidepressant use was 40.4%. After application of adjustments for probable successful outcomes of treatment, the estimated frequency of antidepressant use for major depression was more than 50%. Frequency of antidepressant treatment among those with a history of depression but without a past-year episode increased with the number of previous episodes. Among those taking antidepressants over the past year, only 33.1% had had a past-year episode of major depression. Migraine, fibromyalgia, anxiety disorder, or past depression was present in more than 60% of those taking antidepressants without a past-year episode of depression.
The CCHS results suggest that antidepressant use has increased substantially since the early 1990s, and also that these medications are employed extensively for indications other than depression.
Key wordsantidepressive agents drug utilization major depressive disorder epidemiology Canada health surveys
This study was supported by a grant from the Canadian Institutes of Health Research. Dr. Beck holds a Fellowship from the Canadian Institutes of Health Research and a Clinical Fellowship in Health Research from the Alberta Heritage Foundation for Medical Research. Dr. Patten is a Health Scholar with the Alberta Heritage Foundation for Medical Research. Dr. Maxwell holds a CIHR-IA New Investigator Award and is a Population Health Investigator with the Alberta Heritage Foundation for Medical Research.
- 6.Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, Angermeyer MC, Bernert S, de Girolamo G, Morosini P et al (2004) Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291:2581–2590PubMedGoogle Scholar
- 13.American Psychiatric Association (2000) Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatr 157:1–45Google Scholar
- 14.Statistics Canada. Canadian Community Health Survey: Mental Health and Well-being; Catalogue no. 82-617-XIE. http://www.statcan.ca/english/freepub/82-617-XIE/index.htm. Modified 9 Sep 2004. Cited 10 Jun 2005
- 15.Statistics Canada. Electronic communication regarding Canadian Community Health Survey. Statistics Canada. 8 Sep 2003Google Scholar
- 18.Kessler RC, Abelson J, Demler O, Escobar JI, Gibbon M, Guyer ME, Howes MJ, Jin R, Vega WA, Walters EE et al (2004) Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMHCIDI). Int J Methods Psychiatr Res 13:122–139PubMedGoogle Scholar
- 19.Spitzer RL, Williams JB, Gibbon M, First MB (1990) User's guide for the structured clinical interview for DSM-IIIR. American Psychiatric, Washington, DCGoogle Scholar
- 20.The SAS Institute (2004) The SAS system for Windows. The SAS Institute, Cary, NCGoogle Scholar
- 21.Gravel R (2002) Canadian Community Health Survey: mental health and well-being, public use microdata file guide (82M0021GPE). Statistics Canada, OttawaGoogle Scholar
- 22.Statistics Canada. Canadian community health survey mental health and well-being Cycle 1.2 Master File Documentation. http://www.statcan.ca/english/sdds/document/5015_D4_T1_V1_E.pdf. Modified 13 May 2005. Cited 12 Jun 2005
- 23.Last JM (2001) A dictionary of epidemiology. Oxford University Press, New YorkGoogle Scholar
- 25.Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, Girolamo G, Graaf R, Demyttenaere K, Gasquet I et al (2004) Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl 55–64Google Scholar
- 26.Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, Girolamo G, Graaf R, Demyttenaere K, Gasquet I et al (2004) Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl 21–27Google Scholar
- 33.Lam RW, Kennedy SH (2004) CPA position statement. Prescribing antidepressants for depression in 2005: recent concerns and recommendations. Can J Psychiatr 49:I1–I12Google Scholar
- 41.Statistics Canada Health Statistics Division (1997) National Population Health Survey 1996–97 Household Component User's Guide for the Public Use Microdata Files (82M0009GPE). Minister of Industry, OttawaGoogle Scholar