DEVELOPMENT OF A TYPOLOGY OF ANTIDEPRESSANT USERS: THE ROLE OF MENTAL HEALTH DISORDERS AND SUBSTANCE USE

Main Article Content

Michel Perreault
El Hadj Toure
Marie-Josee Fleury
Serge Beaulieu
Jean Caron

Keywords

Antidepressants, psychotropic medication, mental health, substance use, longitudinal study, profile of use

Abstract

Background / Objectives


Antidepressants constitute one of the most consumed classes of psychotropic medication. This study aims to identify a typology of users based on their individual characteristics, such as presence of a mental disorder and use of other psychotropic medication during the last year .


Methods


Antidepressant use for residents in the epidemiological zone of South- West Montreal aged 15 years and older was documented in 2009, 2011, and 2013. Among the 2433 participants from the initial study, 249 had used antidepressants (10%). A cluster analysis , validated with Chi- square tests and Cramer’s V measure, was conducted with this sample . The longitidinal profile of the clusters was examined using curve clustering .


Results


Based on clinic al variables measured at Time 1 , four types of antidepressant users were identified (p<0,001; 0,58≤V≤0,81) : depressed users without anxiety (15%), anxio -depressive users with substance dependence and polypharmacy (26%) , depressed users with polypharmacy and being treated by a psychiatrist (31%) and users without mental health disorders (28 %) . Follow -ups two and four years later indicate a higher proportion of participants with symptoms of depression persist ing over time within the cohort of persons having concurrent anxiety and substance dependence .


Conclusions


Results help improve knowledge about the context of antidepressant use in order to plan appropriate interventions . Depressed persons without anxiety appear to receive treatment from general practitioners , while those with comorbid psychotic disorders and depression may require specialized treatment from a psychiatrist . A nxio -depressive users with substance dependence and polypharmacy may require integrated services from different specialized networks in order to counter symptoms related to comorbidity .

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