title: Gender differences in psychotropic use across Europe: Results from a large cross-sectional, population-based study.
abstract: BACKGROUND
  In many epidemiological studies, women have been observed to consume psychotropic medication more often than men. However, the consistency of this relationship across Europe, with differences in mental health care (MHC) resources and reimbursement policies, is unknown.
  
  
  METHODS
  Questions on 12-month psychotropic use (antidepressants, benzodiazepines, antipsychotics, mood stabilizers) were asked to 34,204 respondents from 10 European countries of the EU-World Mental Health surveys. Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria were used to determine 12-month prevalence of mood/anxiety disorders using the Composite International Diagnostic Interview (v3.0).
  
  
  RESULTS
  For all participating countries, women were significantly more likely than men to use psychotropic medication within the previous 12 months (overall-OR=2.04, 95% CI: 1.81-2.31). This relationship remained significant after adjusting for common sociodemographic factors (age, income level, employment status, education, marital status) and country-level indicators (MHC provision, private household out-of-pocket expenditure, and Gender Gap Index). In multivariable gender-stratified risk-factor analysis, both women and men were more likely to have taken psychotropic medication with increasing age, decreasing income level, and mental health care use within the past 12 months, with no significant differences between genders. When only including participants with a mental disorder, gender differences overall were still significant with any 12-month mood disorder but not with any 12-month anxiety disorder, remaining so after adjusting for sociodemographic characteristics and country-level indicators.
  
  
  CONCLUSIONS
  Women use psychotropic medication consistently more often than men, yet reasons for their use are similar between genders. These differences also appear to be contingent on the specific mental disorder.
authors.affiliation: École des hautes études en santé publique (EHESP), EA 4057, Paris Descartes University, 75014 Paris, France; Inserm UMR_S1136, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, 75013 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Boyd
authors.affiliation: École des hautes études en santé publique (EHESP), EA 4057, Paris Descartes University, 75014 Paris, France; Ghent University, Ghent, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Van de Velde
authors.affiliation: École des hautes études en santé publique (EHESP), EA 4057, Paris Descartes University, 75014 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Pivette
authors.affiliation: Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Ten Have
authors.affiliation: National School of Public Health, Management and Professional Development, Bucharest, Romania.
authors.forename: S
authors.initials: S
authors.lastname: Florescu
authors.affiliation: Bamford Centre for Mental Health and Well-Being, University of Ulster, Londonderry, Northern Ireland.
authors.forename: S
authors.initials: S
authors.lastname: O'Neill
authors.affiliation: Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: J-M
authors.initials: JM
authors.lastname: Caldas-de-Almeida
authors.affiliation: Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: G
authors.initials: G
authors.lastname: Vilagut
authors.affiliation: Parc Sanitari Sant Joan de Déu, University of Barcelona, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Haro
authors.affiliation: Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Alonso
authors.affiliation: École des hautes études en santé publique (EHESP), EA 4057, Paris Descartes University, 75014 Paris, France. Electronic address: viviane.kovess@ehesp.fr.
authors.forename: V
authors.initials: V
authors.lastname: Kovess-Masféty
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors
chemical_list: D011619:Psychotropic Drugs
keywords: Antidepressant; Anxiety disorders; Benzodiapine; Mood disorders; Mood stabilizers