Evolução dos padrões de consumo de antidepressivos e benzodiazepínicos em uma coorte de funcionários de uma universidade: Estudo Pró-Saúde.

• Autor(a) principal: Alcantara, Geisy de Carvalho
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/4395
• topic: Antidepressants; Benzodiazepines; Prevalence; Incidence; Antidepressivos; Benzodiazepínicos; Prevalência; Incidência; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA

This dissertation aimed to estimate the prevalence, pattern and factors associated with the incidence of antidepressant (AD) and benzodiazepine (BDZ) use in a cohort of university employees. A concurrent cohort study was carried out with data from the Pró-Saúde Study, a longitudinal investigation including all the technical-administrative employees of the actual staff of a university in the State of Rio de Janeiro. Self-administered questionnaires were applied in 1999 (n = 4,030), 2001 (n = 3,574), 2006-07 (n = 3,058) and 2012 (n = 2,933). A database was constructed with 5,369 people covering the four phases, and the prevalence use of AD and BDZ was estimated for each phase. A fixed cohort was defined excluding individuals who entered the study at any phase other than the baseline (phase 1) and/or individuals using AD and BDZ at phase 1. Poisson regression models with robust variance were fitted to estimate the cumulative incidence ratios for the use of AD and BDZ in the period of 1999-2007. The prevalence of use of AD and BDZ in 1999 was 1.4% and 4.7%, respectively. In 2012, the prevalence of use of AD was 5.4% and BDZ was 6.8%. Selective Serotonin Reuptake Inhibitors (SSRI) represented the class responsible for the increase in AD consumption, from 17% in 1999 to 67.6% in 2012. The prevalence use of AD and BDZ were higher among women and those with worse self-perception of general and mental health (measured through GHQ-12). The incidence of psychotropic consumption from 1999 to 2007 was 4.9% (95% CI: 4.2-5.7) for AD and 8.3% (95% CI: 7.3-9.3) for BDZ. When phases 2 and 3 were compared, the increase in the incidence of AD consumption was relatively greater for AD compared to BDZ. The incidence for AD was larger among women compared to men (RR=2.5; 95% CI: 1.75-4.04). Women also had an incidence 58% (95% CI: 30-110) higher for BDZ of use than men. Those with positive GHQ-12 had an incidence 34% greater for both AD and BDZ use. Consistent with the literature, a greater risk of initiating the use of AD was observed among individuals consuming BDZ in phase 1. These results suggest that the increase in the incidence of AD consumption was not followed by a decrease in the incidence of BDZ use. It is imperative that the prescription of AD and BDZ complies with current treatment guidelines, especially considering the rational use of psychotropic drugs. Our findings point to the need to identify patterns similar to those observed in other populations, and aim to contribute to the policies of permanent education of professionals who provide mental health care.