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首页> 外文期刊>Annals of epidemiology >Social inequalities in new antidepressant treatment: A study at the individual and neighborhood levels
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Social inequalities in new antidepressant treatment: A study at the individual and neighborhood levels

机译：新抗抑郁药治疗中的社会不平等：个人和社区水平的研究

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Purpose: To determine whether social inequalities in new antidepressant treatment exist at the individual and/or neighborhood level; and their relation to access to prescribers and/or processes of care (treatment initiation and duration). Methods: We followed 316,412 inhabitants of Marseilles (aged 18-64 years) covered by the National Health Insurance Fund for 2.5 years. We analyzed new treatments (??1 purchase of antidepressants and none in the 6 months before the first one), and new long treatments (??4 within 6 months after the first purchase). We tested their associations with high individual disadvantage and census block deprivation in a multivariate, multilevel logistic model adjusted for consultations with general practitioners and psychiatrists to control for access to care. Results: High individual disadvantage was not associated with the probability of new treatments, but it was with lower odds of receiving new long treatments. Residing in deprived census blocks was associated with lower odds of receiving treatment for both dependent variables. Conclusions: Our results suggest that social inequalities at the individual and neighborhood levels in new antidepressant treatment occur in access to specialty care and in treatment initiation and affect its duration. Further research is warranted to improve our understanding of their mechanisms. ? 2013 Elsevier Inc.
机译：目的：确定在个人和/或社区水平上是否存在新的抗抑郁药治疗中的社会不平等;以及它们与开处方者和/或护理过程（治疗开始和持续时间）的关系。方法：我们追踪了由国家健康保险基金覆盖的316,412名马赛居民（年龄18-64岁），为期2.5年。我们分析了新的治疗方法（第一次购买抗抑郁药为?? 1，而在第一个疗程之前的6个月内没有购买）和新的长期治疗（第一次购买抗抑郁药的6个月内为4）。我们在多变量，多层次的逻辑模型中测试了具有较高个人弱势和人口普查障碍剥夺的协会，该模型经调整可与全科医生和精神病医生进行磋商，以控制获得护理的机会。结果：较高的个人不利因素与新治疗的可能性无关，但与接受新的长期治疗的几率较低。居住在被剥夺的人口普查区与接受这两个因变量治疗的几率较低相关。结论：我们的结果表明，在新的抗抑郁治疗中，个体和社区水平上的社会不平等现象发生在获得专科护理和治疗的初始阶段，并影响其持续时间。有必要进行进一步的研究以增进我们对它们的机制的理解。 ？ 2013爱思唯尔公司

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