Differential characteristics of young and midlife adult users of psychotherapy, psychotropic medications, or both: information from a population representative sample in São Paulo, Brazil.
OBJECTIVE
While the personal characteristics of users of psychotherapy and/or psychotropic medications have been examined, direct user comparison of these treatment approaches appears to be rare. Our aim is to ascertain extent of receipt of these services, and identify basic distinguishing characteristics of users.


METHODS
Information on demographics, lifetime and past 12 month use of mental health services, and presence of common mental disorders (CMD), was gathered in 2002 using a multi-stage sampling procedure that yielded a population-representative, community-resident sample (N = 2000, age 18-65) for São Paulo, Brazil. Analysis used descriptive statistics and logistic regression.


RESULTS
Overall, 9.3% reported receiving psychotherapy and/or psychotropic medication, 54.3% of whom did not meet CMD criteria. Of those meeting criteria for CMD (n = 455, 22.8%), 2.9% reported only psychotherapy, 10.1% reported only psychotropic medication, and 5.7% reported both. CMD was associated with use of psychotropic medication (psychotropic medication alone, Odds Ratio (OR) 3.58, 95% CI 2.33-5.52; together with psychotherapy, OR 4.17, 95% CI 2.34-7.44). CMD was not associated with use of psychotherapy. Users' distinguishing characteristics were: psychotherapy only--not married; psychotropics only--increasing age, female, not married; using both--only CMD status. Neither education nor income was associated with use.


CONCLUSIONS
Nearly 10% of all community residents age 18-65, but less than a fifth of the 23% with CMD, received psychotherapy and/or psychotropic medication. Non-married status increased odds of all treatment types, but CMD presence increased only odds of psychotropic and combined psychotherapy/psychotropic use, with odds of psychotropic only use increasing with age, and for women. Use was equitable with respect to education and income.
Department of Psychiatry, Federal University of São Paulo, (Escola Paulista de Medicina - UNIFESP), R. Borges Lagoa, 570, CEP 04038-020, São Paulo, SP, BRAZIL. blay@uol.com.br.
Sergio L
SL
Blay
Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA. gerda.fillenbaum@duke.edu.
Gerda G
GG
Fillenbaum
Universidade Anhanguera, Rua Maria Cândida, 1.813, CEP: 02071-013, São Paulo, SP, Brazil. pelusoe@terra.com.br.
Erica T
ET
Peluso
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003131:Combined Modality Therapy; D003710:Demography; D005260:Female; D006801:Humans; D016015:Logistic Models; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D011613:Psychotherapy / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012959:Socioeconomic Factors; D055815:Young Adult
D011619:Psychotropic Drugs