title: Patterns of benzodiazepine and antidepressant use among middle-aged adults. the Brazilian longitudinal study of adult health (ELSA-Brasil).
abstract: BACKGROUND
  Antidepressant and benzodiazepine medicines are widely prescribed in high-income countries. Our aim was to investigate and describe clinical and demographic characteristics of their use in a large cohort from a middle-income country.
  
  
  METHODS
  Participants (n=15,105) from the Brazilian Health Longitudinal Study (ELSA-Brasil), a civil servant cohort from six different sites in Brazil were asked about antidepressant and benzodiazepine use. The Clinical Interview Schedule-Revised was used for psychiatric assessment. Sociodemographic and clinical data were also collected.
  
  
  RESULTS
  Current use of antidepressant and benzodiazepine medicines was respectively reported by 6.87% and 3.88% of participants. These numbers were higher in major depression-MDD (16.5% and 13.9%), generalized anxiety disorder-GAD (14% and 9.5%) and any mental disorder (11.7% and 7.8%). The use of antidepressant and benzodiazepine was directly associated with clinical comorbidities and psychiatry diagnosis. In addition, older age was associated with benzodiazepine use and more years of schooling, with antidepressant use. Finally, the use of these medicines was strongly associated (odds ratio=8.48, p<0.001).
  
  
  CONCLUSIONS
  Our cohort does not include younger adults (18-34 years), although it includes older (65-75 years) participants.
  
  
  CONCLUSIONS
  Antidepressant and benzodiazepine use in Brazil is lower than in high-income countries. We found that factors such as age and education level were associated with the use of these medicines, whereas MDD and GAD were poor predictors of psychopharmacotherapy use, suggesting misuse/overuse of psychopharmacotherapy among individuals without psychiatric illness and underuse among those with psychiatric conditions in Brazil.
authors.affiliation: Hospital Universitário, Universidade de São Paulo, São Paulo, Brasil. brunowsky@gmail.com
authors.forename: Andre R
authors.initials: AR
authors.lastname: Brunoni
authors.forename: Maria Angélica
authors.initials: MA
authors.lastname: Nunes
authors.forename: Roberta
authors.initials: R
authors.lastname: Figueiredo
authors.forename: Sandhi M
authors.initials: SM
authors.lastname: Barreto
authors.forename: Maria de Jesus Mendes
authors.initials: Mde J
authors.lastname: da Fonseca
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Benseñor
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy / Q000453:epidemiology; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012737:Sex Factors
chemical_list: D000928:Antidepressive Agents; D001569:Benzodiazepines
keywords: Antidepressant medicines; Benzodiazepine medicines; Clinical epidemiology; Cohort study