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Ann Epidemiol. 2011 Apr;21(4):231-7. doi: 10.1016/j.annepidem.2011.01.005.

Neighborhood deprivation and psychiatric medication prescription: a Swedish national multilevel study.

Author information

1
Stanford Family Medicine, Stanford University, Palo Alto, California 94304-5765, USA. kccrump@stanford.edu

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.

PMID:
21376269
PMCID:
PMC3541429
DOI:
10.1016/j.annepidem.2011.01.005
[Indexed for MEDLINE]
Free PMC Article
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