Encephale
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The consumption of antidepressant seems to be in France higher than in comparable countries, as well as the overall consumption of healthcare and medications. In Western countries, in recent years, the use of antidepressants has regularly increased, mainly due to the use of serotoninergic antidepressants. In France, in a week, the prevalence of antidepressant use in the overall population increased from 1.7% in 1992 to 3% in 1995. ⋯ Women consume more antidepressants than men. SSRIs are the most widely prescribed antidepressants. The survey findings point out the discrepancies between official indications, such as the ones issued by the regulatory authorities, and the physicians' prescribing practices.
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Prescriptions for psychotropic drugs are part of a general practitioner's daily routine. As with all drugs, they need to be controlled by a phenomenon of observance. Respecting prescriptions is in fact a major public health concern. ⋯ Autonomy is a means to responsibility and to valorise a part of the patients in particular those which are non-observing so as to strengthen their capacity to manage their health as best they can. It contributes to a better observance of treatment in as much as autonomous patients are more inclined to negotiate with their doctors. Looking for self-regulatory behaviour allows us a better understanding of those patients non-observers who are willing, and helps them to develop their aptitude to face up to their illness.
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Untreated insomnia often has repercussions on socio-professional or cognitive functioning of insomniacs. In industrialized countries, the prevalence of insomnia ranges between 10% and 48%, depending on the methodology and the measured time interval. However, few studies have examined the relationship between insomnia and mental disorder diagnoses. ⋯ This distinction is important since it helps the physician to determine therapeutic choices. To conclude, it is worthwhile to consider the number of insomnia complainers who had consulted a physician, mainly a general practitioner, in the six months prior to the study. This designates physicians as the first-line resource in the treatment and the prevention of sleep disorders.
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Headache patients frequently overuse analgesic medications: 20% of the patients from headache centers is concerned by this problem, which has been estimated to occur in four percent of the community migrainers. Frequent use of various types of headache medication may paradoxically cause an increase in headache attack frequency as well as their chronicisation due to potentially complex mechanisms of sensitization. Patients will enter into a self- perpetuating cycle of daily headaches and use of symptomatic medications which can lead to addiction and to social and occupational impairement. ⋯ Those patients, when becoming aware of dependance, succeed in withdrawal at home, without the need of an hospitalization. The analgesic medication overuse and dependance can also be considered as a maladjusted strategy to manage pain (with prevalent passive and avoidant coping strategies). More research is required focusing on psychopathological aspects of analgesic overuse and dependance, to improve withdrawal modalities and to reduce the rate of relapses.