Læknablaðið 2004; 90: 553-9

Background: During the past 15 years the use of psycho­tropic medication has increased markedly. The question addressed in this paper is whether this increase is related to change in prevalence of psychiatric disorders or symptoms.

Material and methods: Two data sets were used. Data from a screening of the population aged 20 to 59 years in 1984 using GHQ- 30 and prescriptions for pychotropic medications filled during March that year for outpatients in Reykjavík. Secondly, data from a population screening in January 2002 using GHQ- 12 for the same age range, and all psychotropic prescriptions filled by outpatients in 2001.

Results: The prevalence of those without complaints did not change. It remained about 60%. Using a cut off 4/3 for GHQ-30 and 3/2 for GHQ-12 the prevalence rates were 16.1 % and 17.5%, respectively. By assuming that symptom-free drug users would have reached the cut-off level the prevalence increased to 20.7% Using a cut off score of 3/2 and 2/1, respectively, the prevalence for men in both years was around 18 % while that for women increased from 20.5% to 29.4% (p<0.05). In both years the prevalence was highest in the youngest age group and lowest in the oldest. Psychotropic presciptions other than hypnotics doubled. Proportionally the increase was similar for men and women, but more marked among the younger age groups. The increase in prescriptions filled for all psychotropics was 56% compared to 47% increase in the sale of all medications.

Conclusion: Increase in the use of psychotropics is explained to a limited extent only by possibly higher prevalence of psychiatric disorders. The use of psychotropics has increased along with that of other medications, but at slightly higher pace, which may reflect the results of awareness campaigns among physicians and the general public and more effective and better tolerated medications.