Search

Purpose: The population-based National Health Insurance database was used to investigate the trends, correlates, and disease patterns for elderly people in Taiwan who use antidepressants.Methods: The National Health Research Institute provided a database of 1000,000 random subjects for study. We created a sample of subjects who were older than 65 years from 1997 to 2005. Trends, prevalence, and associated factors of antidepressant use were detected. We also examined the proportion of antidepressant use for psychiatric and medical disorders.Results: The one-year prevalence of antidepressant use in elderly persons increased from 5.8 % in 1997 to 9.8 % in 2005. The one-year prevalence rates of tricyclic antidepressant (TCA), selective serotonin reuptake inhibitor (SSRI), serotonin-norepinephrine reuptake inhibitor (SNRI), serotonin modulator, and other antidepressant use in 2005 were 5.3, 2.6, 0.4, 2.9, and 0.6 %, respectively. Overall antidepressant use was higher for those in the 75- to 84-year-old age group, females, and those with higher Charlson Comorbidity Index scores. Among subjects using TCAs, 77.6 % users did not have a psychiatric diagnosis. Psychiatric disorders were commonly found in most SSRI and SNRI users (85.1 and 90.1 %, respectively). Subjects using SSRIs and SNRIs had higher proportions of psychiatric disorders such as neurotic depression, major depression, senile and presenile organic psychotic conditions, and anxiety.Conclusion: The prevalence of antidepressant use among elderly persons increased greatly from 1997 to 2005. SSRIs, SNRIs, and other antidepressants were used mostly by subjects with psychiatric disorders, whereas TCAs were used mostly by subjects with nonpsychiatric disorders. [ABSTRACT FROM AUTHOR]

Purpose: We used Taiwan’s population-based National Health Insurance database to investigate the trends, correlates, and disease patterns of antipsychotic use among children and adolescents. Methods: The National Health Research Institutes provided a database of 1,000,000 random subjects for study. We chose subjects who were aged 18 years or younger during 1997–2005. In this sample, subjects who were given at least one antipsychotic prescription, including first-generation antipsychotics (FGAs) or second-generation antipsychotics (SGAs), were identified. Trends, prevalence, and associated factors of antipsychotic use were determined. The proportion of antipsychotic use for psychiatric and medical disorders was also analyzed. Results: The 1-year prevalence of SGA use increased from 0.00 % in 1997 to 0.09 % in 2005, whereas the 1-year prevalence of FGA use ranged from 2.24 to 3.43 % during this same period, with no significant change. Age and male gender were associated with higher SGA use. Among SGA users, the greatest proportion suffered from psychiatric disorders, including tics, hyperkinetic syndrome of childhood, schizophrenia, affective disorders, and autism. Among FGA users, a larger proportion was for medical conditions, including diseases of the digestive and respiratory systems. Conclusion: The prevalence of pediatric SGA use increased greatly from 1997 to 2005. Among pediatric subjects using antipsychotics, SGAs were mostly used for psychiatric disorders, whereas FGAs were mostly prescribed for medical conditions. Future research will focus on indication, dosage, frequency, duration, adverse effects, and off-label use of antipsychotics in the pediatric population. [ABSTRACT FROM AUTHOR]

Purpose: We used National Health Insurance (NHI) database to examine the prevalence, incidence, and stimulant use of attention-deficit hyperactivity disorder (ADHD) diagnosis in Taiwan. Methods: The National Health Research Institute provided a database of 10,00,000 random subjects for study. A population-based random sample of 372,642 patients aged younger than 18 was obtained as a dynamic cohort. Those study subjects who had at least one service claim from 1996 to 2005, with a principal diagnosis of ADHD, were identified. Results: The cumulative prevalence of ADHD diagnosis increased from 0.06 to 1.64 % from 1996 to 2005. The annual incidence of ADHD diagnosis increased from 0.02 to 0.34 % from 1997 to 2005. The highest incidence rates of ADHD diagnosis for both males and females were in the 6- to 11-year age group. Higher incidence was detected in males (HR 3.76, 95 % CI 3.48-4.07), those who lived in northern region (HR 1.35, 95 % CI 1.07-1.71) and urban area (HR 1.53, 95 % CI 1.40-1.66). The percentage of stimulant use in children with ADHD diagnosis increased from 39.6 to 54.0 % from 1997 to 2005. Conclusions: Our findings suggest increases in the prevalence and incidence rates of ADHD diagnosis in Taiwan, which was in line with those studies of Western countries. However, the prevalence of ADHD diagnosis in the NHI program was still much lower than in the community studies. The percentage of stimulant use in children with ADHD diagnosis also has an increasing trend, which warrants further study. [ABSTRACT FROM AUTHOR]

Purpose: We used the population-based National Health Insurance database to investigate correlates and psychiatric disorders associated with psychotropic drug use in Taiwan. Methods: The National Health Research Institute provided a database of 200,000 random subjects for study. We obtained a random sample of 145,304 subjects aged 18 years or older in 2004. Study subjects who had made at least two psychotropic drug prescriptions during this year were identified. We detected factors associated with psychotropic drug use. In addition, we examined the prevalence of antipsychotic, antidepressant, mood stabilizer, sedative-hypnotic-anxiolytic (SHA) agent, and any psychotropic drug use according to psychiatric disorders. Results: Higher prevalence of any psychotropic drug use was found in the 25-44, 45-64, and 65 or older age groups, females, aborigine, with a lower premium, with disability, and among those who lived in central region, suburban or rural area. Among those subjects with any major psychiatric disorders, the prevalence of antipsychotic, antidepressant, mood stabilizer, SHA agent, and any psychotropic drug use were 59.3, 49.7, 17.9, 78.6, and 92.0%, respectively. Among those subjects with any minor psychiatric disorders, the prevalence of antipsychotic, antidepressant, mood stabilizer, SHA agent and any psychotropic drug use were 17.5, 41.8, 4.0, 85.5, and 89.4%, respectively. Conclusions: Thus, those subjects with any psychiatric disorders had a high percentage of any psychotropic drug use in National Health Insurance program in Taiwan. Future studies should focus on the outcome evaluation and correlates associated with individual psychotropic use. [ABSTRACT FROM AUTHOR]

We used the NHI database to estimate the treated prevalence and incidence of bipolar disorder. The national health research institute (NHRI) provided a population based data file of 200,432 random subjects, about 1% of the population, for the study. We obtain a random sample of 136,045 subjects as a fixed cohort from 1996 to 2003. We identified study subjects who had at least one service claim during these years for either ambulatory or inpatient care with a principal diagnosis of bipolar disorder. The cumulative treated prevalence increased from 0.60 per 1,000 to 4.51 per 1,000 from 1996 to 2003. The annual treated incidence was around 0.48 per 1,000 per year to 0.71 per 1,000 per year during 1997-2003. Higher treated incidence was detected in the 45-64 (hazard ratio [HR], 1.63; 95% CI, 1.26-2.12) and 65 years or older age groups (HR, 1.57; 95% CI, 1.14-2.15), female (HR, 1.23; 95% CI, 1.04-1.46), non-aborigine (HR, 3.12; 95% CI, 1.26-7.75), with a fixed premium (HR, 1.60; 95% CI, 1.18-2.17), and those who lived in the eastern region (HR, 3.26; 95% CI, 2.31-4.59). According to the trends from 1996 to 2003, more persons with bipolar disorder had sought treatment in the NHI program in Taiwan. However, the treated prevalence of bipolar disorder in NHI was still lower than those of community studies in Western countries. In the future, we will continue to use NHI data to perform outcome evaluation and follow-up studies of bipolar disorder. [ABSTRACT FROM AUTHOR]