Room
Auditoire Georges Spengler (gegenüber dem Eingang)
Theme
Mental Health - Important points for mental
health
Chair
Mauricio Avendano
Title
Trends
in long-term use of antidepressants in Switzerland and associated risk
factors: 2013 – 2021
Name
Melanie Amrein
Affiliation
Department of Health Sciences, Helsana Insurance Group
Abstract
Background: Antidepressant use has increased in many European countries, driven by longer treatment duration. The aim of this study was to provide prevalence rates of long-term users of antidepressants for the Swiss population over the last decade and to investigate associated risk factors for longer use.Methods: In a retrospective cohort study, we examined the prevalence rates of indi-viduals with at least one prescription for antidepressants using longitudinal health claims data. To compare different lengths of prescription duration, we defined short-term (<6 months), medium-term (6-12 months) and long-term users (>12 months). We applied a bina-ry logistic regression model to investigate the effects of population characteristics and treat-ment patterns on long-term compared to short- and medium-term users.
Results: The proportion of long-term users was substantial and increased steadily from 2014 to 2020. The numbers of medium- and short-term users have decreased during this period. The 1-year-prevalence of individuals with at least one antidepressant prescription remained stable over the past decade. Older age, being a woman, living in a nursing home, living in an urban area, living in the Italian speaking part of Switzerland, and being enrolled in a managed care plan, were all factors associated with long-term users.
Conclusions: Since 2014, the proportion of long-term users in Switzerland has been steadily increasing. This study highlights risk factors associated with long-term use. Taking antidepressants longer than recommended may indicate possible overprescribing. Given the ongoing debate about the confounding effects of relapse and withdrawal, more research is needed to investigate antidepressants overprescribing, particularly for specific populations.
Title
Prenatal
exposure to antidepressants and trends in prescription in Switzerland from
2012 to 2019: A health care claims analysis
Name
Marc Dupuis
Affiliation
Institute of Primary Health Care (BIHAM), University
of Bern, Switzerland
Abstract
About 10% of gravid women experience major depressive disorder and more than 15% show symptoms of depressive episodes during pregnancy, making depression in the perinatal period an important public health concern. Because women are not always respondent to psychotherapy, antidepressant medication is necessary despite suspected risks of obstetrical complications or infant-development issues. About 2.5% of the women in Switzerland and in France take antidepressant medications during pregnancy, with a clear decrease during its first trimester.There is however a lack of knowledge on antidepressant medication during pregnancy. To fill this gap, we developed a cohort of pregnant patients. The cohort is based on health care claims from CSS insurance, and includes information from TARMED, SwissDRG systems, especially diagnoses and medical prescriptions. Every patient with a diagnosed pregnancy included in CSS database from 2012 to 2019 were included, the ones being not observed during the entire duration of pregnancy and cases of terminations being excluded.
The cohort has three purposes:
First, to measure prenatal exposure to different drugs in Switzerland.
Second, to observe trends in medical prescription during pregnancy across time.
Third, at a later stage, to develop causal inference models and to have a better understanding of potential risks inherent with some medications.
From a total of 144,724 records of pregnancies and 89,191 women, 18,819 were excluded due to termination of pregnancy, 21,433 were duplicates, and 374 were excluded due to contradictious or ambiguous information about pregnancy. The cohort consists so far of 104,098 pregnancies and 80,320 pregnant participants.
For about 14% of the recorded pregnancies, women used antidepressant between 2012 and 2019, 3.0% in the perinatal period and 1.3% specifically during pregnancy. Continued antidepressant medication for the entire duration of pregnancy represents 0.3% of the recorded medications.
The aim of the presentation will be to detail the estimated prevalence of drug exposure by drug and by trimester of pregnancy. The results will also be put into perspective in regard to yearly trends in prescriptions.
Title
Selbsthilfegruppen
als ergänzendes Angebot in der Gesundheitsversorgung
Name
Elena Konstantinidis
Affiliation
Selbsthilfe Schweiz
Abstract
In der Schweiz gibt es rund 2700 Selbsthilfegruppen zu 350 Themen mit 45'000 Teilnehmenden. Drei Viertel der Gruppen tauschen sich über ein Thema im Bereich der somatischen oder psychischen Gesundheit aus. Neben Gruppen für Patienten spielen auch Gruppen für betreuende bzw. pflegende Angehörige eine wichtige Rolle. Selbsthilfegruppen spielen insbesondere eine wichtige Rolle bei chronischen und seltenen Krankheiten sowie für ältere Betroffene (über 50jährige).Der Beitrag von Selbsthilfegruppen zur Gesundheitskompetenz und dem Selbstmanagement von Patienten ist mehrfach untersucht und belegt worden. Die Teilnehmenden in den Gruppen vermitteln einander gegenseitig Zugang zu Informationen über ihre Erkrankung und deren Behandlung sowie über die Bewältigung der Herausforderungen, die im Alltag durch diese entstehen. Damit fangen die Selbsthilfegruppen viele soziale und psychische Probleme auf, deren Bearbeitung im Rahmen der ärztlichen oder pflegerischen Versorgung nicht geleistet werden kann. Teilnehmende an Selbsthilfegruppen nutzen medizinische Angebote gezielter und kooperieren besser mit den Anweisungen des medizinischen Personals. Selbsthilfegruppen stellen somit ein kostengünstiges, niederschwelliges ambulantes Angebot in der Gesundheitsversorgung dar.
Im Projekt «Selbsthilfefreundliche Spitäler» baut die Stiftung Selbsthilfe Schweiz seit mehreren Jahren die systematische Zusammenarbeit von Gesundheitsversorgung und Selbsthilfe auf. Experten aus Ärzteschaft, Pflege und Sozialwesen (regionale Selbsthilfe-Fachstellen) fördern gemeinsam mit Betroffenen aus den Selbsthilfegruppen den Zugang von Patienten zu den Selbsthilfegruppen in einer Region. Diese erhalten damit eine zusätzliche Unterstützung an der Schnittstelle von stationärer Behandlung, ambulanter Nachsorge und Selbstmanagement in der alltäglichen Lebenswelt. Aus den Erfahrungen in diesem Projekt können zudem Schlussfolgerungen für die Zusammenarbeit von Selbsthilfe und ambulanter Primärversorgung gezogen werden.
Title
A psychosocial perspective on Long-COVID: A cross-sectional survey study
Name
Janina Lüscher
Affiliation
Swiss Paraplegic Research
Abstract
Increasingly, attention of COVID-19 infections is directed toward their long-term effects, also known as Long-COVID. So far, Long-COVID has been examined mainly from a medical perspective, leaving psychosocial effects on health-related outcomes of Long-COVID understudied. The present study advances the current literature by examining social support in the context of Long-COVID. The study not only examines received support reported by individuals with Long-COVID but also provided support reported by relatives of individuals with Long-COVID.The cross-sectional study was conducted from June to October 2021 in the German-speaking part of Switzerland, Austria, and Germany. We examined 256 individuals with Long-COVID and 50 relatives of individuals with Long-COVID in two separate online surveys, assessing social support, well-being, and distress. For individuals with Long-COVID, receiving emotional support was related to higher well-being and less distress. No effects emerged for receiving practical support. For relatives of individuals with Long-COVID, providing emotional support was related to lower depressive symptoms. Provided practical support was again unrelated to the outcomes considered. Emotional support is likely to play an important role for well-being and distress of individuals with Long-COVID and relatives of individuals with Long-COVID, whereas practical support does not seem to make a difference in the present population. Future research should clarify under what conditions different kinds of support unfold their positive effects on well-being and distress in the context of Long-COVID.
Title
A
case time series analysis of military aircraft noise exposure and sedative
use in a psychiatric clinic
Name
Benedikt Wicki
Affiliation
SwissTPH
Abstract
Existing evidence suggests that noise exposure can increase the risk for adverse mental health outcomes, such as psychiatric hospitalizations and even suicide. To investigate acute effects of noise on patients suffering from mental health disorders, we assessed short-term associations between fighter jet noise and on-demand sedative drug consumption in a psychiatric clinic located close to a military airfield in Switzerland. We applied a case-time-series analysis using distributed-lag models with an hourly time resolution, stratified by stays at the clinic. Noise exposure was modelled using detailed flight plans and noise footprints for different aircraft and route combinations. Hourly LAeq was used as main exposure metric. Outcome data was available from the clinic’s records. During the study period (06/2016–12/2021), 23,486 flights with a mean estimated LAE of 80.49 dB (SD: 8.04) at the clinic’s main building occurred. 5,968 stays with a mean length of 41.62 days (SD: 29.53) and a mean number of 17.56 medication doses (SD: 26.28) were included. Analysis was adjusted for long-term and seasonal trends, day of week, time of day, time-varying weather conditions (temperature, sunshine duration, foehn wind episodes) and the week of stay to account for a treatment effect. Time-constant, individual confounders such as diagnoses and age were accounted for by design. We found that the odds for medication consumption increased by 2.3% (OR: 1.023 [95%CI: 1.003, 1.045]) per 10dB LAeq of aircraft noise over the lag period of 0-12 hours. These results suggest that loud noise events can lead to acute feelings of distress in psychiatric patients.