Factors associated with antidepressant, anxiolytic and hypnotic use over 17 years in a national cohort

BACKGROUND: In the general population, most individuals with mental disorders are not treated with psychotropic medications. The objective of this study was to identify factors associated with psychotropic medication use over a 17 year period in a birth cohort. METHOD: Members of the 1946 British birth cohort (n = 2928 in 1999) reported psychotropic medication use in 1982 at age 36, in 1989 at age 43, and in 1999 at age 53. At each of the three time points, several factors were investigated for their association with antidepressant, anxiolytic or hypnotic medication use. RESULTS: After adjusting for severity of symptoms of depression and anxiety, clinical factors such as suicidal ideation, sleep difficulty and poor physical health were strongly associated with antidepressant, anxiolytic or hypnotic medication use in 1982 and 1989, but not in 1999. Non-clinical factors were infrequently associated with antidepressant, anxiolytic or hypnotic medication use in 1982 and 1989 after adjusting for severity of symptoms, however several non-clinical factors were associated with antidepressant, anxiolytic or hypnotic medication use in 1999 including being female (OR = 1.4, 95% CI: 1.0, 1.9), unemployment (OR = 2.9, 95% CI: 2.1, 4.1), living alone (OR = 2.6, 95% CI: 1.7, 3.9), and being divorced, separated or widowed (OR = 1.5, 95% CI: 1.1, 2.3). LIMITATIONS: Data were not available on help-seeking behaviour. CONCLUSIONS: Treatment of mental disorder with psychotropic medications is strongly associated with clinical factors. However, non-clinical factors continue to be significant, and may influence both treatment-seeking and prescribing behaviour.