The relationship between self-reported mental health and redeemed prescriptions of antidepressants: a register-based cohort study.
Poor mental health is a major problem in most western societies, especially predominant among young adults. However, associations of self-reported poor mental health with subsequent psychiatric or medical treatment are unknown. We examined the relation between self-reported mental health and redeeming prescriptions of antidepressants among three age groups.



We analyzed data from 16,233 individuals aged 16 years and over randomly selected to participate in the 2010 North Denmark Region Health Survey completed in February 2010. Mental health was defined according to the Short-Form 12 instrument (SF-12) and dichotomized into poor and good. Outcome data were retrieved from administrative information on redeemed prescriptions of antidepressants between February 2010 and December 2012. Crude cumulative incidence curves were produced to illustrate the probability of redeeming new prescriptions of antidepressants over time. Cox regression analysis was used to estimate risk of redeeming prescriptions of antidepressants when having poor mental health, adjusted for preselected explanatory covariates.



Among the young (16-29 years-old), 620 (23 %) participants suffered from poor mental health. Among the adults (30-59 years-old) and elderly (60 years-old or over), 1592 (18 %) participants and 723 (15 %) reported poor mental health, respectively. Overall, women were more likely than men to rate their mental health as poor. For all age groups, there was an increased probability for redeeming prescriptions of antidepressants when having poor mental health. The hazard ratio [HR] for redeeming prescriptions of antidepressants for those reporting poor versus good mental health, adjusted for sex, ethnicity, marital status, education level, occupational status, smoking and physical activity was 3.1 (95 % confidence interval [CI] 2.20-4.29) for young participants. For adults, the HR was 2.3 (95 % CI 1.86-2.78) and for elderly, it was 3.5 (95 % CI 2.66-4.57).



Self-reported poor mental health was more frequent among younger than older participants. Overall, antidepressants were the most often used treatment. An increased probability of redeeming antidepressant prescriptions when having self-reported poor mental health was observed in all age groups. These findings suggest that frequent reporting of poor mental health is a common issue for all age groups that needs more attention.
Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220, Aalborg, Denmark. guddifrandsen@hotmail.com.
Louise Sjørslev
LS
Frandsen
Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220, Aalborg, Denmark.
Line Bilgrav
LB
Villumsen
Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220, Aalborg, Denmark.
Cathrine Fonnesbech
CF
Hjorth
Department of Clinical Epidemiology, Aalborg University Hospital, Sdr. Skovvej 15, DK-9000, Aalborg, Denmark.
Berit Jamie
BJ
Nielsen
Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220, Aalborg, Denmark.
Line Rosenkilde
LR
Ullits
Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220, Aalborg, Denmark.|Department of Clinical Epidemiology, Aalborg University Hospital, Sdr. Skovvej 15, DK-9000, Aalborg, Denmark.
Christian
C
Torp-Pedersen
Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220, Aalborg, Denmark.
Henrik
H
Bøggild
Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220, Aalborg, Denmark.
Charlotte
C
Overgaard
D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D057566:Self Report; D055815:Young Adult
D000928:Antidepressive Agents
Antidepressant agents; Mental health; Sex differences; Young