title: Use of antidepressants in the treatment of major depressive disorder in primary care during a period of economic crisis.
abstract: OBJECTIVE
  To describe antidepressant (AD) use in the treatment of major depressive disorder during a period of economic crisis.
  
  
  METHODS
  This was a retrospective, observational study using population-based databases. Two periods were considered: 1) 2008-2009, precrisis, and 2) 2012-2013, economic crisis. Certain inclusion/exclusion criteria were taken into account for the study (initiation of AD treatment). Patients were followed up for 12 months. The main measures were use (defined daily doses), epidemiologic measures, strategies used and treatment persistence, referrals, and use of resources. Statistical significance was set at P<0.05.
  
  
  RESULTS
  In the precrisis period, 3,662 patients were enrolled, and 5,722 were enrolled in the period of economic crisis. Average age was 58.8 years and 65.4% were women. Comparing the two periods, major depressive disorder prevalence was 5.4% vs 8.1%, P<0.001. During the period of economic crisis, AD use rose by 35.2% and drug expenditures decreased by 38.7%. Defined daily dose per patient per day was 10.0 mg vs 13.5 mg, respectively, P<0.001. At 12-month follow-up, the majority of patients (60.8%) discontinued the treatment or continued on the same medication as before, and in 23.3% a change of AD was made.
  
  
  CONCLUSIONS
  Primary health care professionals are highly involved in the management of the illness; in addition, during the period of economic crisis, patients with major depressive disorder showed higher rates of prevalence of the illness, with increased use of AD drugs.
authors.affiliation: Research Unit, Badalona Serveis Assistencials SA, Badalona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Sicras-Mainar
authors.affiliation: Medical Documentation Unit, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Ruth
authors.initials: R
authors.lastname: Navarro-Artieda
keywords: antidepressants; consumption; economic crisis