title: Use of psychotropic medications in São Paulo Metropolitan Area, Brazil: pattern of healthcare provision to general population.
abstract: OBJECTIVE
  We estimate the proportion of psychotropic medication use (PMU) among adults in São Paulo Metropolitan Area, Brazil. We investigated whether socio-demographic factors, comorbidity, and disease severity influence PMU among individuals with psychiatric disorders.
  
  
  METHODS
  Data are from the São Paulo Megacity Mental Health Survey, a cross-sectional, population-based study, the Brazilian branch of the World Mental Health Survey Initiative. Trained lay interviewers face-to-face assessed psychiatric disorders and PMU through the Composite International Diagnostic Interview. Respondents were asked about use of healthcare service and prescribed medications for mental disorders in the previous year. Information on PMU was collected for 2935 adult residents in the area and among those with disorders who received treatment.
  
  
  RESULTS
  Around 6% of respondents reported PMU in the past year: hypnotics or sedatives were used by 3.7% and antidepressants by 3.5%. Among individuals with 12-month disorders, only 14% reported past year PMU. Gender, age, education, income, occupational status, comorbidity, and severity were significant predictors for PMU. Among those with 12-month DSM-IV disorders who obtained treatment in healthcare settings, almost 40% received medication only. Among those treated in specialty mental health service, around 23% received combination of medication and psychotherapy.
  
  
  CONCLUSIONS
  Our study has pointed out that the recent trend of access to mental healthcare in Brazil depicts unmet needs, characterized by a low prevalence of PMU among individuals with psychiatric disorders. Policies that improve appropriate access to prescribed drugs for those most in need are urgent public health priority.
authors.affiliation: Section of Psychiatric Epidemiology (LIM-23), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, SP, Brazil.|Department of Pharmacy, State University of Maringá, Maringá, PR, Brazil.
authors.forename: Angela Maria
authors.initials: AM
authors.lastname: Campanha
authors.affiliation: Section of Psychiatric Epidemiology (LIM-23), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, SP, Brazil.
authors.forename: Erica Rosanna
authors.initials: ER
authors.lastname: Siu
authors.affiliation: Institute of Mathematics and Statistics, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Igor André
authors.initials: IA
authors.lastname: Milhorança
authors.affiliation: Department of Social Medicine, Health Sciences Center, Federal University of Espírito Santo, Vitória, ES, Brazil.
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Viana
authors.affiliation: Section of Psychiatric Epidemiology (LIM-23), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, SP, Brazil.
authors.forename: Yuan-Pang
authors.initials: YP
authors.lastname: Wang
authors.affiliation: Section of Psychiatric Epidemiology (LIM-23), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, SP, Brazil.
authors.forename: Laura Helena
authors.initials: LH
authors.lastname: Andrade
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000503:physiopathology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: mental disorders/epidemiology; mental disorders/therapy; pharmacoepidemiology; psychotropic drugs