The EU referendum and mental health in the short term: a natural experiment using antidepressant prescriptions in England.
Antidepressive Agents
/ therapeutic use
Depression
/ drug therapy
Drug Prescriptions
/ statistics & numerical data
Drug Utilization Review
European Union
Female
General Practice
/ trends
Humans
Hypnotics and Sedatives
/ therapeutic use
Male
Mental Health
Practice Patterns, Physicians'
/ statistics & numerical data
United Kingdom
depression
mental health
public health
Journal
Journal of epidemiology and community health
ISSN: 1470-2738
Titre abrégé: J Epidemiol Community Health
Pays: England
ID NLM: 7909766
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
15
02
2018
revised:
18
10
2018
accepted:
19
10
2018
pubmed:
23
11
2018
medline:
3
6
2020
entrez:
23
11
2018
Statut:
ppublish
Résumé
Previous research has highlighted the impact of economic conditions and uncertainty on physical and mental health. The unexpected result of the Brexit referendum in 2016 triggered high levels of economic uncertainty. To examine whether prescriptions for antidepressants increased after the referendum result, benchmarking them against other drug classes. We used GP practice prescribing data to compile the number of defined daily doses per capita every month in each of the 326 voting areas in England over the period 2011-2016. We used a difference-in-differences (DID) approach to identify the effects of Brexit on antidepressant prescriptions, compared with trends in a control group (antigout and iron preparations) that were unlikely to be associated with uncertainty and depression. Antidepressant prescribing continued to increase after the referendum but at a slower pace. Therapeutic classes used as controls showed a decrease. The DID approach shows that there was a relative increase of 13.4% in antidepressants compared with other therapeutic classes (DID coeff: 0.134; 95% CI 0.093 to 0.174). Our results are open to different interpretations and should be treated with caution. This relative increase in antidepressant prescribing after the referendum may be attributed to increased uncertainty for certain parts of the population, but does not rule out an improvement in mood for others. Alternatively, some other factor-for example, distraction, might have contributed to a decrease in the control therapeutic classes. A possible policy implication is that programmes for the promotion of mental health may need to be intensified during periods of uncertainty.
Sections du résumé
BACKGROUND
Previous research has highlighted the impact of economic conditions and uncertainty on physical and mental health. The unexpected result of the Brexit referendum in 2016 triggered high levels of economic uncertainty.
OBJECTIVE
To examine whether prescriptions for antidepressants increased after the referendum result, benchmarking them against other drug classes.
METHODS
We used GP practice prescribing data to compile the number of defined daily doses per capita every month in each of the 326 voting areas in England over the period 2011-2016. We used a difference-in-differences (DID) approach to identify the effects of Brexit on antidepressant prescriptions, compared with trends in a control group (antigout and iron preparations) that were unlikely to be associated with uncertainty and depression.
RESULTS
Antidepressant prescribing continued to increase after the referendum but at a slower pace. Therapeutic classes used as controls showed a decrease. The DID approach shows that there was a relative increase of 13.4% in antidepressants compared with other therapeutic classes (DID coeff: 0.134; 95% CI 0.093 to 0.174).
CONCLUSION
Our results are open to different interpretations and should be treated with caution. This relative increase in antidepressant prescribing after the referendum may be attributed to increased uncertainty for certain parts of the population, but does not rule out an improvement in mood for others. Alternatively, some other factor-for example, distraction, might have contributed to a decrease in the control therapeutic classes. A possible policy implication is that programmes for the promotion of mental health may need to be intensified during periods of uncertainty.
Identifiants
pubmed: 30464033
pii: jech-2018-210637
doi: 10.1136/jech-2018-210637
doi:
Substances chimiques
Antidepressive Agents
0
Hypnotics and Sedatives
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
168-175Informations de copyright
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.