title: Psychotropic drug initiation during the first diagnosis and the active treatment phase of B cell non-Hodgkin's lymphoma: a cohort study of the French national health insurance database.
abstract: Patients with B cell non-Hodgkin's lymphomas (B-NHLs) are known to be at risk of developing psychological disorders. The aims of this study were to measure the incidence of psychotropic drug use during the diagnosis and the active treatment phase in comparison with controls from the general population, and to identify factors associated with this use.
  
  
  
  B-NHL patients were selected through the French national health insurance database in the Midi-Pyrénées region (southwestern France) from January 1, 2011, to April 31, 2013. Patients with a previous history of B-NHL and/or psychotropic drug treatment were excluded.
  
  
  
  Among 745 newly diagnosed B-NHL patients, psychotropic treatment was initiated in 31.5 % (95 % CI [28.1-34.9]), compared to 7.6 % (95 % CI [7.57-7.64]) in the general population during the same period. This incidence was comparable in colorectal cancer patients (33.5 %) but higher than that in patients with myocardial infarction (23.5 %) or with a first knee replacement surgery (22.4 %). Anxiolytics and hypnotics were the most frequently used drugs. Median duration of treatment was 37 days for anxiolytics and 58 days for hypnotics, with 20.8 % of patients remaining under treatment at 8 months. Factors associated with psychotropic drug initiation were young age, health care consumption in the year before diagnosis, and initial care at a university hospital.
  
  
  
  The high rate of psychotropic drug initiation reflects a high level of anxiety at the initial phase of B-NHL patients' trajectory. This pharmacoepidemiological study reveals inappropriate use in some patients, which should now be investigated in lymphoma survivorship.
authors.affiliation: Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université Paul Sabatier, Toulouse, France.|Laboratoire de Pharmacologie Médicale et Clinique, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France.|UMR1027, Inserm, Université Paul Sabatier, Toulouse, France.|INSERM CIC 1436 Toulouse, Centre d'Investigation Clinique de Toulouse, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Conte
authors.affiliation: Laboratoire de Pharmacologie Médicale et Clinique, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France.
authors.forename: Manuela
authors.initials: M
authors.lastname: Rueter
authors.affiliation: UMR1027, Inserm, Université Paul Sabatier, Toulouse, France.|Departement d'Hématologie et de Médecine Interne, Institut Universitaire du Cancer-Oncopole, 1 Avenue Irène Joliot-Curie, Toulouse, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Laurent
authors.affiliation: Caisse Nationale d'Assurance Maladie Midi-Pyrénées, 3 Boulevard Léopold Escande, 31105, Toulouse, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Bourrel
authors.affiliation: Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université Paul Sabatier, Toulouse, France.|Laboratoire de Pharmacologie Médicale et Clinique, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France.|UMR1027, Inserm, Université Paul Sabatier, Toulouse, France.|INSERM CIC 1436 Toulouse, Centre d'Investigation Clinique de Toulouse, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
authors.forename: Maryse
authors.initials: M
authors.lastname: Lapeyre-Mestre
authors.affiliation: Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université Paul Sabatier, Toulouse, France. fabien.despas@univ-tlse3.fr.|Laboratoire de Pharmacologie Médicale et Clinique, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France. fabien.despas@univ-tlse3.fr.|UMR1027, Inserm, Université Paul Sabatier, Toulouse, France. fabien.despas@univ-tlse3.fr.|INSERM CIC 1436 Toulouse, Centre d'Investigation Clinique de Toulouse, Centre Hospitalier Universitaire de Toulouse, Toulouse, France. fabien.despas@univ-tlse3.fr.
authors.forename: Fabien
authors.initials: F
authors.lastname: Despas
mesh_terms: D000368:Aged; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends*; D005260:Female; D005602:France; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000209:etiology; D009313:National Health Programs / Q000639:trends*; D017891:Pharmacoepidemiology / Q000379:methods*; D011619:Psychotropic Drugs / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D011619:Psychotropic Drugs
keywords: French national health insurance database; Non-Hodgkin’s lymphoma; Pharmacoepidemiology; Psychological disorders; Psychotropic drugs