Differences in psychotropic drug prescriptions among ethnic groups in the Netherlands

Abstract

Background Psychotropic drug use in Europe and the USA has increased in the past 20 years. The rise in mental health-care use instigated a debate about possible differences in prevalence rates between different ethnic groups in the Netherlands, although the exact differences were unknown. The aim of this study was to determine whether these minority groups were more or less likely than the native population to receive psychotropic drugs. Methods A descriptive population study was conducted using the Agis Health Database, containing demographic and health-care consumption data of approximately 1.5 million inhabitants of the Netherlands. Rates of prescriptions of psychotropic drugs from 2001 to 2006 and adjusted odds ratios for psychotropic drug prescriptions among native Dutch, Turkish and Moroccan ethnic groups were calculated. These data were analysed using logistic regression, after being adjusted for age, gender and socioeconomic status. Results The mean year prevalence of psychotropic drug prescriptions from 2001 to 2006 was 14.0%. Except for a decrease in anxiolytic drugs, the prescriptions of psychotropic drugs increased from 2001 to 2006. These trends were the same for all of the ethnic groups considered. Among both the Moroccan and Turkish populations, there was a higher risk of antidepressant and antipsychotic drug prescriptions, and a pronounced lower risk of ADHD medication and lithium prescriptions compared to the native population. Among the Turkish population, the risk of anxiolytic drug prescriptions was greater than in the native population. Conclusions Compared to the native population in the Netherlands, first-and second-generation Turkish and Moroccan immigrants had an increased risk of antidepressant and antipsychotic drug prescriptions and a decreased risk of ADHD medication and Lithium prescriptions. Further research is needed to clarify whether patients of different ethnic backgrounds with the same symptoms receive similar diagnosis and adequate treatment.

Prevalence, determinants and spectrum of attention-deficit hyperactivity disorder (ADHD) medication of children and adolescents in Germany: results of the German Health Interview and Examination Survey (KiGGS)

“…With respect to the association of ADHD medication use and immigration background our results correspond to those of various studies 9–2142 In a population-based study of the prescription data of the largest health insurance company in the Netherlands, Wittkampf et al 42 report that ADHD medication is less likely to be prescribed to children of Turkish and Moroccan families than to Dutch boys and girls. This may either point to differential thresholds to healthcare services for immigrants or may even be due to culturally altered attitudes towards symptoms of ADHD.…”

Prevalence and correlates of psychotropic medication use among older adults in Israel: Cross-sectional and longitudinal findings from two cohorts a decade apart

“…These findings can be related partly to a cultural preference to home remedies observed in more traditional societies or to poorer communication with the family physician due to language barriers or cultural restraint in discussing emotional distress with the family physician (Fuchs et al, 2003; Geulayov,Lipsitz, Gross, 2010) . Similar findings were observed in The Netherlands where a decreased risk of ADHD medications was shown among Turkish and Moroccan immigrants as compared to the native population (Wittkampf et al, 2010). Lower use of psychotropic medications by Orthodox Jews was also observed in the former mentioned Israeli national study which pointed to the negative attitudes of Orthodox Jews to mental disorders (Grinshpoon et al, 2007).…”

“…Trends in the use of psychotropic medications across time were assessed on the basis of nationally representative cross-sectional health surveys at two or more points in time (Paulose-Ram, Safran, Jonas, Gu, & Orwig, 2007; Wittkampf et al, 2010; Zuvekas, 2005), national/municipal data for prescribing these medications by general practitioners (Middleton, Gunnell, Whitley, Dorling, & Frankel, 2001) or drugs sales statistics (Isacson & Smedby, 1988). Generally, information with regard to older individuals can be retrieved from population-based studies.…”

Association between immigrant background and ADHD: a nationwide population‐based case–control study

“…The inconsistent findings reflect varying study contexts and methodological problems, such as small or selected samples, questionnaire information based only on parent or self‐reports, cross‐sectional designs, study populations limited to restricted geographical areas, and lack of health record–based information about diagnoses. The use of ADHD medication has been shown to be less frequent among children who themselves or whose parents are immigrants (Galera et al., ; Gimeno‐Feliu, Armesto‐Gómez, Macipe‐Costa, & Magallón‐Botaya, ; Knopf, Holling, Huss, & Schlack, ; Wittkampf et al., ), which may be explained by sociocultural aspects, insurance policies, and lack of access to health care. Medication is not a very reliable proxy indicator for ADHD per se, and among immigrants, in particular, because of negative attitudes toward medication in many cultural contexts (Barnard‐Brak & To, ; Dosreis et al., ).…”