The epidemiology of antidepressant use in South Korea: Does short-term antidepressant use affect the relapse and recurrence of depressive episodes?


Autoři: Min Ji Kim aff001;  Namwoo Kim aff001;  Daun Shin aff001;  Sang Jin Rhee aff001;  C. Hyung Keun Park aff001;  Hyeyoung Kim aff004;  Sung Joon Cho aff005;  Jae Won Lee aff006;  Eun Young Kim aff007;  Boram Yang aff009;  Yong Min Ahn aff001
Působiště autorů: Department of Psychiatry, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea aff001;  Department of Psychiatry and Behavioral Science, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea aff002;  Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea aff003;  Department of Psychiatry, Inha University Hospital, Inhang-ro, Jung-gu, Incheon, Republic of Korea aff004;  Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea aff005;  Dept. of Psychiatry Seoul Metropolitan Eunpyeong Hospital, dept. of Psychiatry, Eunpyeong-gu, Seoul, Republic of Korea aff006;  Mental Health Center, Seoul National University Health Care Center, Gwanak-gu, Seoul, Republic of Korea aff007;  Department of Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea aff008;  Medical Research Collaborating Center, Seoul National University Hospital, Seoul, South-Korea aff009
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222791

Souhrn

Background

The duration of antidepressant use affects the treatment of depression. Using the National Health Insurance database, which covers almost the entire national population, we verified the factors associated with the inadequate short-term use of initially prescribed antidepressants and their effects on the relapse and recurrence of depressive episodes.

Methods

There were 752,190 patients included who had been newly prescribed antidepressants in 2012 with the diagnosis of depressive disorder. They were followed-up until December 31, 2015. They were classified as short-term and long-term antidepressant users depending on whether they used a specific initial antidepressant for at least four weeks. Sociodemographic, clinical, and medical utilization factors affecting the duration of antidepressant use were investigated. We also identified whether the duration of antidepressant use affected the risk of relapse and recurrence, which was defined by the restarting of antidepressants.

Results

Initial antidepressants were taken for less than 28 days by 458,057 (60.84%) patients. Tricyclic antidepressants were used as the initial antidepressant more frequently than selective serotonin reuptake inhibitors (64.5% versus 19.3%). The type of initial antidepressant, polypharmacy, psychiatric and medical comorbidities, type of insurance coverage, and type of medical institution visited were associated with short-term use. Short-term use marginally increased the risk of relapse and recurrence of depressive episodes (Hazard ratio: 1.06, 95% confidence intervals 1.048–1.075).

Conclusions

Short-term antidepressant use is widespread in Korea, and assessment in various aspects are necessary to set proper treatment plans.

Klíčová slova:

Antidepressants – Cardiology – Depression – Health insurance – Mental health and psychiatry – Oncology – Pulmonology – Reuptake inhibitors


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