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Neighborhood Deprivation and Psychiatric Medication Prescription: A Swedish National Multilevel Study

Crump, Casey; Sundquist, Kristina LU ; Sundquist, Jan LU and Winkleby, Marilyn A. (2011) In Annals of Epidemiology 21(4). p.231-237
Abstract
PURPOSE: Previous studies of neighborhood deprivation and mental disorders have yielded mixed results, possibly because they were based on different substrata of the population. We conducted a national multilevel study to determine whether neighborhood deprivation is independently associated with psychiatric medication prescription in a national population. METHODS: Nationwide outpatient and inpatient psychiatric medication data were analyzed for all Swedish adults (N = 6,998,075) after 2.5 years of follow-up. Multilevel logistic regression was used to estimate the association between neighborhood deprivation (index of education, income, unemployment, and welfare assistance) and prescription of psychiatric medications (antipsychotics,... (More)
PURPOSE: Previous studies of neighborhood deprivation and mental disorders have yielded mixed results, possibly because they were based on different substrata of the population. We conducted a national multilevel study to determine whether neighborhood deprivation is independently associated with psychiatric medication prescription in a national population. METHODS: Nationwide outpatient and inpatient psychiatric medication data were analyzed for all Swedish adults (N = 6,998,075) after 2.5 years of follow-up. Multilevel logistic regression was used to estimate the association between neighborhood deprivation (index of education, income, unemployment, and welfare assistance) and prescription of psychiatric medications (antipsychotics, antidepressants, anxiolytics, or hypnotics/sedatives), after adjusting for broadly measured individual-level sociodemographic characteristics. RESULTS: For each psychiatric medication class, a monotonic trend of increasing prescription was observed by increasing level of neighborhood deprivation. The strongest associations were found for antipsychotics and anxiolytics, with adjusted odds ratios of 1.40 (95% confidence interval [CI], 1.36-1.44) and 1.24 (95% CI, 1.22-1.27), respectively, comparing the highest-to the lowest-deprivation neighborhood quintiles. CONCLUSIONS: These findings suggest that neighborhood deprivation is associated with psychiatric medication prescription independent of individual-level sociodemographic characteristics. Further research is needed to elucidate the mechanisms by which neighborhood deprivation may affect mental health and to identify the most susceptible groups in the population. Ann Epidemiol 2011;21:231-237. (C) 2011 Elsevier Inc. All rights reserved. (Less)
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type
Contribution to journal
publication status
published
subject
keywords
Anti-Anxiety Agents, Antidepressive Agents, Antipsychotic Agents, Hypnotics and Sedatives, Residence Characteristics
in
Annals of Epidemiology
volume
21
issue
4
pages
231 - 237
publisher
Elsevier
external identifiers
  • wos:000288295900001
  • scopus:79952091339
ISSN
1047-2797
DOI
10.1016/j.annepidem.2011.01.005
language
English
LU publication?
yes
id
93ddd46b-ee62-4396-96c0-656c1aeb237d (old id 1868784)
date added to LUP
2011-04-04 07:23:20
date last changed
2017-11-12 03:17:06
@article{93ddd46b-ee62-4396-96c0-656c1aeb237d,
  abstract     = {PURPOSE: Previous studies of neighborhood deprivation and mental disorders have yielded mixed results, possibly because they were based on different substrata of the population. We conducted a national multilevel study to determine whether neighborhood deprivation is independently associated with psychiatric medication prescription in a national population. METHODS: Nationwide outpatient and inpatient psychiatric medication data were analyzed for all Swedish adults (N = 6,998,075) after 2.5 years of follow-up. Multilevel logistic regression was used to estimate the association between neighborhood deprivation (index of education, income, unemployment, and welfare assistance) and prescription of psychiatric medications (antipsychotics, antidepressants, anxiolytics, or hypnotics/sedatives), after adjusting for broadly measured individual-level sociodemographic characteristics. RESULTS: For each psychiatric medication class, a monotonic trend of increasing prescription was observed by increasing level of neighborhood deprivation. The strongest associations were found for antipsychotics and anxiolytics, with adjusted odds ratios of 1.40 (95% confidence interval [CI], 1.36-1.44) and 1.24 (95% CI, 1.22-1.27), respectively, comparing the highest-to the lowest-deprivation neighborhood quintiles. CONCLUSIONS: These findings suggest that neighborhood deprivation is associated with psychiatric medication prescription independent of individual-level sociodemographic characteristics. Further research is needed to elucidate the mechanisms by which neighborhood deprivation may affect mental health and to identify the most susceptible groups in the population. Ann Epidemiol 2011;21:231-237. (C) 2011 Elsevier Inc. All rights reserved.},
  author       = {Crump, Casey and Sundquist, Kristina and Sundquist, Jan and Winkleby, Marilyn A.},
  issn         = {1047-2797},
  keyword      = {Anti-Anxiety Agents,Antidepressive Agents,Antipsychotic Agents,Hypnotics and Sedatives,Residence Characteristics},
  language     = {eng},
  number       = {4},
  pages        = {231--237},
  publisher    = {Elsevier},
  series       = {Annals of Epidemiology},
  title        = {Neighborhood Deprivation and Psychiatric Medication Prescription: A Swedish National Multilevel Study},
  url          = {http://dx.doi.org/10.1016/j.annepidem.2011.01.005},
  volume       = {21},
  year         = {2011},
}