engleski

Consumption of Antidepressants in Croatia: Trends in the Rate of Hospitalization for Depression and Suicide (2001-2010)

Aims: To assess the effect of antidepressant consumption on the rate of hospitalization for depression and suicide. Methods: The epidemiological method of descriptive and analytical observation was used in 10-year study. Hospitalization data were collected for every patient hospitalized for depression. Suicide data were obtained from mortality statistics. Data on drug utilization from Zagreb Municipal Pharmacy were used to calculate the number of defined daily doses (DDD) and DDD per 1000 inhabitants per day (DDD/TID) using the WHO Anatomical-Therapeutic- Chemical methodology. On DDD/TID calculation, data from the 2001 census were used , according to which the population of Zagreb was 770 058. Results: From 2001 to 2010, the rate of hospitalization for depression was reduced from 17.3/10, 000 to 15.4/10, 000. The mean length of hospital stay was reduced from 34.9 to 31.2 days. The rate of suicide decreased from 19.9/100, 000 to 14/100, 00. From 2001 to 2010, consumption of antidepressants increased by 89, 8% (from 10.8 to 20.5 DDD/TID) in outpatient health care. The highest rise was recorded in the outpatient consumption of SSRI by 106% (from 6.9 to 14.2 DDD/TID). Outpatient consumption of nonselective inhibitors of monoamine reuptake decreased by 46% (from 3.9 to 2.1 DDD/TID). The anxiolytic/antidepressant ratio decreased from 6, 45 to 2.55. Conclusions: The rate of hospitalization for depression decreased, the mean length of hospital stay was reduced, the rate of suicide decreased, while consumption of antidepressants, especially SSRI increased. The anxiolytic/antidepressant ratio as quality indicator decreased significantly. These trends reflect an improved psychiatric management through intensive programs, outpatient follow- up, and treatment with specific antidepressants. Respective education of family physicians in clinical psychopharmacology is of utmost importance for early recognition and treatment of mild and moderate depressive disorders.

antidepressant consumption, depression, hospitalization, suicide, City of Zagreb

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