Psychotropic drug use in Northern Ireland 1966–80: prescribing trends, inter- and intra-regional comparisons and relationship to demographic and socioeconomic variables | Psychological Medicine | Cambridge Core (original) (raw)

Synopsis

A study of psychotropic drug prescribing, derived from the computerized pricing data in Northern Ireland from 1966, showed that the use of these drugs reached a peak in 1975, when about 12·5% of the adult population were estimated to have been receiving them, and declined in the following 5 years. Benzodioazepines accounted for three-quarters of all psychotropic drugs prescribed in 1980. Benzodiazepine tranquillizer prescribing was consistently 20–30% higher than in the rest of the United Kindom, in contrast to hypnotic and antidepressant prescribing which has been consistently lower. The rate of increase in benzodiazepine tranquillizer prescribing was greater than in other European countries, but the level remains lower than in Iceland and Denmark. The influence of a number of demographic and socioeconomic variables was studied in an intra-regional analysis of the 1978 data for the 17 health districts in the province, using multivariate and multiple regression statistics. The prescribing of benzodiazepine hypnotics was almost entirely accounted for by the proportion of elderly (over 65 years) and women aged 45–59 years; neuroleptic prescribing was largely a function of factors associated with rural areas (overcrowding and unemployment) and the proportion of elderly; but neither tranquillizer, antidepressant, barbiturate hypnotic nor psychostimulant prescribing were satisfactorily explained by these variables.

References

Anderson, R. (1980). Prescribed medicines: who takes what? Journal of Epidemiology and Community Health 34, 299–304.CrossRefGoogle Scholar

Balter, M. B., Levine, J. & Manheimer, D. I. (1974). Cross-national study of the extent of anti-anxiety/sedative drug use. New England Journal of Medicine 290, 769–774.CrossRefGoogle ScholarPubMed

Blaney, R. & Mackenzie, G. (1980). The prevalence of problem drinking in Northern Ireland: a population study. International Journal of Epidemiology 9, 159–166.CrossRefGoogle ScholarPubMed

Böethius, G. & Westerholm, B. (1977). Purchases of hypnotics, sedatives and minor tranquillizers among 2566 individuals in the county of Jamtland, Sweden – a 6 years'follow up. Acta psychiatrica scandinavica 56, 147–159.Google Scholar

Clare, A. W. (1971). Diazepam, alcohol and barbiturate abuse. British Medical Journal iv, 340.CrossRefGoogle Scholar

Committee on the Review of Medicines (1980). Systematic review of benzodiazepines. British Medical Journal 280, 910–912.Google Scholar

Dean, G., Downing, H. & Shelley, E. (1981). First admissions to psychiatric hospitals in south-east England in 1976 among immigrants from Ireland. British Medical Journal 282, 1831–1833.CrossRefGoogle ScholarPubMed

Dennis, P. J. (1979). Monitoring of psychotropic drug prescribing in general practice. British Medical Journal ii. 1115–1116.CrossRefGoogle Scholar

Dunnell, K. & Cartwright, A. (1972). Medicine Takers, Prescribers and Hoarders, pp. 75–77. Routledge and Kegan Paul: London.Google Scholar

Elmes, P. C., Hood, H., McMeekin, C. & Wade, O. L. (1976 a). Prescribing in Northern Ireland: study number 1, sleeping tablets. Ulster Medical Journal 45, 166–177.Google Scholar

Elmes, P. C., Hood, H. & Wade, O. L. (1976 b). Prescribing in Northern Ireland: methods of analysis. Ulster Medical Journal 45, 56–58.Google ScholarPubMed

Faris, R. E. L. & Dunham, H. W. (1939). Mental Disorders in Urban Areas. University of Chicago Press: Chicago.Google Scholar

Fraser, R. M. (1971). The cost of commotion: an analysis of the psychiatric sequelae of the 1969 Belfast riots. British Journal of Psychiatry 118, 257–264.CrossRefGoogle ScholarPubMed

Galle, O. R., Gove, W. R. & McPherson, J. M. (1972). Population density and pathology: What are the relations for man? Science 176, 23–30.CrossRefGoogle ScholarPubMed

Grímsson, A. & Ólafsson, Ó. (1981). Drug prescriptions in Reykjavik according to age, sex and marital status. In Drugs in Iceland (ed. Ólafsson, Ó.), pp. 65–74. Landlaeknisembaettid: Reykjavik.Google Scholar

Grímsson, A., Idänpään-Heikkilä, J., Lunde, P. K. M., Ólafsson, Ó. & Westerholm, B. (1979). The utilization of psychotropic drugs in Finland, Iceland. Norway and Sweden. In Studies in Drug Utilization: Methods and Applications (ed. Bergman, U., Grímsson, A., Wahba, A. H. W. and Westerholm, B.), pp. 163–167. WHO Regional Publications European Series No 8. WHO Regional Office for Europe: Copenhagen.Google Scholar

Helgason, T. (1964). Epidemiology of mental disorders in Iceland. Acta psychiatrica scandinavica, Suppl. 173, pp. 165–166. Munksgaard: Copenhagen.Google Scholar

Holding, T. A., Buglass, D., Duffy, J. C. & Kreitman, N. (1977). Parasuicide in Edinburgh a seven year review 1968 74. British Journal of Psychiatry 130, 534–543.CrossRefGoogle Scholar

Hollingshead, A. B. & Redlich, F. C. (1958). Social Class and Mental Illness: A Community Study, p. 210. Wiley: New York.CrossRefGoogle Scholar

Howie, J. G. R. & Bigg, A. R. (1980). Family trends in psychotropic and antibiotic prescribing in general practice. British Medical Journal 280. 836–838.CrossRefGoogle ScholarPubMed

Idänpään-Heikkilä, J. (1977). Use of anxiolytics, sedatives, hypnotics. antidepressants and neuroleptics in Finland in 1966–1976. Suomen Apteekkarilehti 1, 20–31.Google Scholar

Idänpään-Heikkilä, J. (1979). Data collection in Finland. In Studies in Drug Utilization: Methods and Applications (ed. Bergman, U., Grímsson, A., Wahba, A. H. W. and Westerholm, B.), pp. 35–48. WHO Regional Publications European Series No. 8. WHO Regional Office for Europe: Copenhagen.Google Scholar

Joyce, C. R. B., Last, J. M. & Weatherall, M. (1968). Personal factors as a cause of differences in prescribing by general practitioners. British Journal of Preventive and Social Medicine 22. 170–177.Google ScholarPubMed

King, D. J., McMeekin, C. & Elmes, P. C. (1977). Are we as depressed as we think we are? Ulster Medical Journal 46, 105–112.Google ScholarPubMed

King, D. J., Griffiths, K., Hall, C. E., Cooper, N. C. & Morrison, D. J. (1980). Effect of the CURB campaign on barbiturate prescribing in Northern Ireland. Journal of the Royal College of General Practitioners 30, 614–618.Google ScholarPubMed

Langner, T. S. & Michael, S. T. (1963). Life Stress and Mental Health. The Midtown Manhattan Study. Thomas A. C. Rennie Series in Social Psychiatry vol. 2. Collier-Macmillan: London.Google Scholar

Lunde, P. K. M., Baksaas, I., Halse, M., Halvorsen, I. K., Strømnes, B. & Øydvin, K. (1979). The methodology of drug utilization studies. In Studies in Drug Utilization: Methods and Applications (ed. Bergman, U., Grímsson, A., Wahba, A. H. W. and Westerholm, B.), pp. 17–28. WHO Regional Publications European Series No. 8. WHO Regional Office for Europe: Copenhagen.Google Scholar

Lyons, H. A. (1972). Depressive illness and aggression in Belfast. British Medical Journal i, 342–345.CrossRefGoogle Scholar

Lyons, H. A. (1977). Psychological sequelae of the terrorist bombing. The Police Surgeon 12, 52–59.Google Scholar

Maletzky, B. M. & Klotter, J. (1976). Addiction to diazepam. The International Journal of Addictions 11 (1), 95–115.CrossRefGoogle ScholarPubMed

McDevitt, D. G. & McMeekin, C. (1979). Data collection in Northern Ireland. In Studies in Drug Utilization: Methods and Applications (ed. Bergman, U., Grímsson, A., Wahba, A. H. W. and Westerholm, B.), pp. 103–111. WHO Regional Publications European Series No. 8. WHO Regional Office for Europe: Copenhagen.Google Scholar

Moore, B. G., Geddes, G. L. & Patterson, A. W. (1981). Prescribed doses of benzodiazepines. Unit for Research into Drug Usage. Heriot-Watt University, Edinburgh.Poster presentation at WHO Drug Utilization Research Group Meeting,Korčula,28 30 April.Google Scholar

Murray, D. (1976). Ulster– the tranquillized province? Belfast Telegraph, 15 06.Google Scholar

Nordic Council on Medicines (1979 a). Nordic Statistics on Medicines. 1975–1977, Part I. Helsingfors.Google Scholar

Nordic Council on Medicines (1979 b). The Anatomical Therapeutic Chemical Classification System (ATC) and Defined Daily Doses. Nordic Statistics on Medicines 1975–1977. Part II. Helsingfors.Google Scholar

Ödegaard, O. (1973). Norwegian emigration, re-emigration and internal migration. In Uprooting and After (ed. Zwingmann, C. A. and Pfister-Ammende, M.), pp. 169–174. Springer-Verlag: Berlin.Google Scholar

Ogburn, W. (1964). On Culture and Social Change. Selected papers edited with an introduction by Duncan, O. D.. p. 101. University of Chicago Press: Chicago.Google Scholar

Ólafsson, Ó. (1981). Prescription habits of G.P. in Reykjavik and rural areas of Iceland on hypnotics and psychotropic drugs. In Drugs in Iceland (ed. Ólafsson, Ó.). pp. 33–40. Landlaeknisembaettid: Reykjavik.Google Scholar

Ólafsson, Ó., Sigfússon, S. & Grímsson, A. (1980). Control of addictive drugs in Iceland 1976–1978. Journal of Epidemiology and Community Health 34, 305–308.CrossRefGoogle Scholar

Parkin, D. (1979). Distance as an influence on demand in general practice. Journal of Epidemiology and Community Health 33, 96–99.CrossRefGoogle ScholarPubMed

Petursson, H. & Lader, M. H. (1981 a). Withdrawal reaction from clobazepam. British Medical Journal 282, 1931–1932.CrossRefGoogle Scholar

Petursson, H. & Lader, M. H. (1981 b). Withdrawal from long-term benzodiazepine treatment. British Medical Journal 283, 643–645.CrossRefGoogle ScholarPubMed

Registrar General (1973). Annual Statistical Review, England and Wales. Part 1. Tables Medical. HMSO: London.Google Scholar

Rickels, K. (1981). Are benzodiazepines overused and abused? British Journal of Clinical Pharmacology 11, 71S–83S.CrossRefGoogle ScholarPubMed

Royal College of General Practitioners, Office of Population Censuses and Surveys, and Department of Health and Social Security (1979). Morbidity Statistics from General Practice 1971–1972, p. 119. Second National Study. Studies on Medical and Population Subjects No. 36. HMSO: London.Google Scholar

Schweitzer, L. & Su, W-H. (1977). Population density and the rate of mental illness. American Journal of Public Health 67, 1165–1172.CrossRefGoogle ScholarPubMed

Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. (1966). Psychiatric Illness in General Practice, pp. 97–105. Oxford University Press: London.Google Scholar

Skegg, D. C. G., Doll, R. & Perry, J. (1977). Use of medicines in general practice. British Medical Journal i, 1561–1563.CrossRefGoogle Scholar

Stolley, P. D., Becker, M. H., Lasagna, L., McEvilla, J. D. & Sloane, L. M. (1972). The relationship between physician characteristics and prescribing appropriateness. Medical Care 10, 17–28.CrossRefGoogle ScholarPubMed

Trethowan, W. H. (1975). Pills for personal problems. British Medical Journal iii, 749–751.CrossRefGoogle Scholar

Tyrer, P. (1978). Drug treatment of psychiatric patients in general practice. British Medical Journal ii, 1008–1010.CrossRefGoogle Scholar

Tyrer, P., Rutherford, D. & Huggett, T. (1981). Benzodiazepine withdrawal symptoms and propranolol. Lancet i, 520–522.CrossRefGoogle Scholar

Walsh, D. (1971). Patients in Irish psychiatric hospitals in 1963– a comparison with England and Wales, British Journal of Psychiatry 118, 617–620.CrossRefGoogle ScholarPubMed

Westerholm, B. (1979). Data collection in Sweden. In Studies in Drug Utilization: Methods and Applications (ed. Bergman, U., Grímsson, A., Wahba, A. H. W. and Westerholm, B.), pp. 73–82. WHO Regional Publications European Series No. 8. WHO Regional Office for Europe: Copenhagen.Google Scholar