Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-10T12:06:48.977Z Has data issue: false hasContentIssue false

Rates and predictors of anti-depressant prescribing in Northern Ireland 2011–2015: a data linkage study using the Administrative Data Research Centre (NI)

Published online by Cambridge University Press:  29 April 2019

Mark Shevlin*
Affiliation:
School of Psychology and Psychology Research Institute, Ulster University, Londonderry, UK
Michael Rosato
Affiliation:
Bamford Centre for Mental Health and Wellbeing, Ulster University, Londonderry, UK
Stephanie Boyle
Affiliation:
School of Psychology and Psychology Research Institute, Ulster University, Londonderry, UK
Daniel Boduszek
Affiliation:
School of Human and Health Sciences, Department of Psychology, University of Huddersfield, Huddersfield, UK
Jamie Murphy
Affiliation:
School of Psychology and Psychology Research Institute, Ulster University, Londonderry, UK
*
*Address for correspondence: Mark Shevlin, Ulster University, Magee Campus, Northland Road, Londonderry BT48 7JL, Northern Ireland, UK (Email: m.shevlin@ulster.ac.uk)

Abstract

Objectives:

Research indicates that anti-depressant prescribing is higher in Northern Ireland (NI) than in the rest of the UK, and that socio-economic and area-level factors may contribute to this. The current study provides comprehensive population-based estimates of the prevalence of anti-depressant prescription prescribing in NI from 2011 to 2015, and examined the associations between socio-demographic, socio-economic, self-reported health and area-level factors and anti-depressant prescription.

Methods:

Data were derived from the 2011 NI Census (N = 1 588 355) and the Enhanced Prescribing Database. Data linkage techniques were utilised through the Administrative Data Research Centre in NI. Prevalence rates were calculated and binary logistic analysis assessed the associations between contextual factors and anti-depressant prescription.

Results:

From 2011 to 2015, the percentages of the population in NI aged 16 or more receiving anti-depressant prescriptions were 12.3%, 12.9%, 13.4%, 13.9% and 14.3%, respectively, and over the 5-year period was 24.3%. The strongest predictors of anti-depressant prescription in the multivariate model specified were ‘very bad’ (OR = 4.02) or ‘Bad’ general health (OR = 3.98), and self-reported mental health problems (OR = 3.57). Other significant predictors included social renting (OR = 1.67) and unemployment (OR = 1.25). Protective factors included Catholic religious beliefs, other faith/philosophic beliefs and no faith/philosophic beliefs in comparison to reporting Protestant/other Christian religious beliefs (ORs = 0.78–0.91).

Conclusion:

The prevalence of anti-depressant prescription in NI appears to be higher than the prevalence of depressive disorders, although this may not necessarily be attributable to over-prescribing as anti-depressants are also prescribed for conditions other than depression. Anti-depressant prescription was linked to several factors that represent socio-economic disadvantage.

Type
Original Research
Copyright
© College of Psychiatrists of Ireland 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abel, GA, Barclay, ME, Payne, RA (2016). Adjusted indices of multiple deprivation to enable comparisons within and between constituent countries of the UK including an illustration using mortality rates. BMJ Open 6(11), e012750.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). doi:10.1176/appi.books.9780890423349.Google Scholar
Andrade, L, Caraveo-Anduaga, JJ, Berglund, P, Bijl, RV, Graaf, RD, Vollebergh, W, Dragomirecka, E, Kohn, R, Keller, M, Kessler, RC, Kawakami, N (2003). The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. International Journal of Methods in Psychiatric Research 12(1), 321.CrossRefGoogle ScholarPubMed
Bosqui, TJ, Maguire, A, Kouvonen, A, Wright, D, Donnelly, M, O’Reilly, D (2017). Ethnic density and risk of mental ill health–the case of religious sectarianism in Northern Ireland: a population data linkage study. Health & Place 47, 2935. doi: 10.1016/j.healthplace.2017.06.010.CrossRefGoogle ScholarPubMed
Bunting, BP, Murphy, SD, O’Neill, SM, Ferry, FR (2012). Lifetime prevalence of mental health disorders and delay in treatment following initial onset: evidence from the Northern Ireland Study of Health and Stress. Psychological Medicine 42(8), 17271739.CrossRefGoogle ScholarPubMed
Bunting, BP, Ferry, FR, Murphy, SD, O’Neill, SM, Bolton, D (2013). Trauma associated with civil conflict and posttraumatic stress disorder: evidence from the Northern Ireland study of health and stress. Journal of Traumatic Stress 26(1), 134141.CrossRefGoogle ScholarPubMed
Butterworth, P, Olesen, SC, Leach, LS (2013). Socioeconomic differences in antidepressant use in the PATH through life study: evidence of health inequalities, prescribing bias, or an effective social safety net? Journal of Affective Disorders 149(1), 7583. https://doi.org/10.1016/j.jad.2013.01.006.CrossRefGoogle ScholarPubMed
Donnelly, KJ (2014). Primary Care Prescribing. Northern Ireland Audit Office: Belfast. (Retrieved from http://www.niauditoffice.gov.uk/primary_care_prescribing-2.pdf). Accessed 18 May 2018].Google Scholar
isdscotland (2018). Medicines used in Mental Health, Years 2007/08 – 2017/18. Retrieved from https://www.isdscotland.org/Health-Topics/Prescribing-and-Medicines/Publications/2018-10-09/2018-10-09-PrescribingMentalHealth-Report.pdf [Accessed 20 Feb. 2019].Google Scholar
Kelly, CB, Ansari, T, Rafferty, T, Stevenson, M (2003). Antidepressant prescribing and suicide rate in Northern Ireland. European Psychiatry 18(7), 325328.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Koretz, D, Merikangas, KR, Rush, AJ, Walters, EE, Wang, PS (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA, 289(23), 30953105.CrossRefGoogle Scholar
Kessler, RC, Aguilar-Gaxiola, S, Alonso, J, Chatterji, S, Lee, S, Ormel, J, Üstün, TB, Wang, PS (2009). The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiology and Psychiatric Sciences 18(1), 2333.CrossRefGoogle ScholarPubMed
Koenen, K, Ratanatharathorn, A, Ng, L, McLaughlin, K, Bromet, E, Stein, D, Karam, EG, Ruscio, AM, Benjet, C, Scott, K, Kessler, R (2017). Posttraumatic stress disorder in the World Mental Health Surveys. Psychological Medicine 47(13), 22602274. doi: 10.1017/S0033291717000708.CrossRefGoogle ScholarPubMed
Mental Health Foundation (2005). Up and Running? Exercise Therapy and the Treatment of Mild or Moderate Depression in Primary Care. Mental Health Foundation: London.Google Scholar
Newton, JN, Briggs, AD, Murray, CJ, Dicker, D, Foreman, KJ, Wang, H, Naghavi, M, Forouzanfar, MH, Ohno, SL, Barber, RM, Vos, T (2015). Changes in health in England, with analysis by English regions and areas of deprivation, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet 386(10010), 22572274.CrossRefGoogle ScholarPubMed
NISRA (2005). Report of the Inter-Departmental Urban-Rural Definition Group Statistical Classification and Delineation of Settlements February 2005. Northern Ireland Statistical and Research Agency.Google Scholar
Northern Ireland Statistics and Research Agency. (2010). The Northern Ireland Multiple Deprivation Measure 2010. Department of Finance and Personnel for Northern Ireland, Belfast.Google Scholar
O’Reilly, D, Stevenson, M (2003). Mental health in Northern Ireland: have “the Troubles” made it worse? Journal of Epidemiology & Community Health 57(7), 488492.CrossRefGoogle ScholarPubMed
O’Reilly, D, Rosato, M, Catney, G, Johnston, F, Brolly, M (2011). Cohort description: The Northern Ireland Longitudinal Study (NILS). International Journal of Epidemiology 41(3), 634641.CrossRefGoogle Scholar
Spiers, N, Qassem, T, Bebbington, P, McManus, S, King, M, Jenkins, R, Meltzer, H, Brugha, T (2016). Prevalence and treatment of common mental disorders in the English national population, 1993–2007. British Journal of Psychiatry 209(2), 150156. doi: 10.1192/bjp.bp.115.174979CrossRefGoogle ScholarPubMed
Weich, S, Twigg, L, Lewis, G (2006). Rural/non-rural differences in rates of common mental disorders in Britain: Prospective multilevel cohort study. British Journal of Psychiatry 188(1), 5157. doi: 10.1192/bjp.bp.105.008714CrossRefGoogle ScholarPubMed
Wemakor, A, Casson, K, Dolk, H (2014). Prevalence and sociodemographic patterns of antidepressant use among women of reproductive age: A prescription database study. Journal of Affective Disorders 167, 299305.CrossRefGoogle Scholar
Wong, J, Motulsky, A, Eguale, T, Buckeridge, DL, Abrahamowicz, M, Tamblyn, R (2016). Treatment indications for antidepressants prescribed in primary care in Quebec, Canada, 2006–2015. JAMA 315(20), 22302232.CrossRefGoogle Scholar