title: Effects of the Financial Crisis on Psychotropic Drug Consumption in a Cohort from a Semi-Urban Region in Catalonia, Spain.
abstract: OBJECTIVE
  Evidence of whether the recent economic crisis has or has not had an effect on psychotropic drug consumption is very scarce. Our objective was to determine if there had in fact been an increase in psychotropic drug use as a result of the financial crisis.
  
  
  METHODS
  In our study a retrospective cohort (between January 1, 2005, and December 31, 2012) was made up of individuals from the general population in a region in the northeast of Catalonia, Spain. We specified a generalized linear mixed model along with combined 'selection on observables' as (propensity scoring) matching and 'selection on unobservables' as (random coefficient) the panel data model methods, and performed inferences using a Bayesian framework.
  
  
  RESULTS
  In the period following the economic crisis (post 2009), there was an increase in the consumption of psychotropic drugs which was significantly higher among those who had already been consuming psychotropic drugs prior to 2009 and those most likely to be unemployed. The increase was of greater significance when consumption was measured by the number of drugs being taken, rather than by the defined daily dose (DDD), with the greatest increase occurring in 2011; the very year in which Spain was most affected by the crisis.
  
  
  CONCLUSIONS
  Once the financial crisis had ended, there was an increase in the severity, rather than the intensity, of mental health disorders in individuals who had already had disorders before the crisis. This increase occurred in those most likely to be unemployed, and the severity was accentuated in the toughest year of the economic crisis.
authors.affiliation: Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.|CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Barceló
authors.affiliation: Cambian Churchill Hospital, Mental Health Services, London, United Kingdom.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Coll-Negre
authors.affiliation: Research Support Unit, University Institute of Research in Primary Care Jordi Gol (IdIAP Gol), Girona, Spain.|Department of Medical Sciences, University of Girona, Girona, Spain.|CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Coll-de-Tuero
authors.affiliation: Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.|CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Saez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001499:Bayes Theorem; D003863:Depression / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000503:physiopathology; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data*; D057172:Economic Recession; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000503:physiopathology; D011619:Psychotropic Drugs / Q000191:economics / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D014478:Unemployment / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D011619:Psychotropic Drugs