Overmedication due to a shortage of psychologists: 15 million antidepressants prescribed in a decade in Catalonia

BarcelonaNearly half a million Catalans received specialized care for mental health disorders between 2010 and 2019, before the pandemic exacerbated the population's emotional distress. During this period, 67 million medications were prescribed to treat these illnesses, a fifth of which were antidepressants alone. This equates to 15.7 million antidepressants over 10 years, according to a study led by the Hospital Clínic of Barcelona. This is the most accurate snapshot to date of the state of mental health care in Catalonia, revealing conclusions such as the growing shortage of professionals and a high "prescribing burden," which, in part, seeks to address the lack of professionals within the system.

The study, published in the journal European PsychiatryThis stems from an initial study focused on primary care, in which the authors observed a fivefold increase in antidepressant prescriptions over the same period, without a corresponding increase in diagnoses of mental health disorders. Eduard Vieta, head of the psychiatry and psychology department at the Hospital Clínic and the IDIBAPS group, clarifies that these medications are indicated for disorders beyond depression, such as anxiety or certain types of pain, but acknowledges that with more resources and staff, better care could be provided to those suffering from these illnesses. He maintains, however, that these prescriptions are not incorrect. These prescriptions are being made in a context of a "historical shortage of clinical psychologists" and with retirements on the horizon that will exacerbate the current lack of professionals, Vieta states. Therefore, the expert emphasized the importance of addressing the staffing shortages in mental health care: "Prescribing practices could be improved if we had better access to specialists." Between 2010 and 2019, 13.9 million benzodiazepines, anxiolytics prescribed primarily for insomnia and anxiety, and 9.1 million antipsychotics were also prescribed. Regarding the type of illness, the most frequently diagnosed during this period were anxiety (31.38%), mood disorders (18.83%), and substance use disorders (13.59%).

Overweight and smoking

The key to this study, according to its authors, is that it offers a "solid foundation for improving public policies and care for people with mental disorders," since its results were obtained from the PADRIS-PRESTO cohort, a large database with information on more than 1.4 million people in Catalonia between 2010 and 2019. This includes data from mental health professionals in Catalonia, both those receiving care for mental health disorders and those without a psychiatric diagnosis. This has allowed the authors to develop a precise profile of the type of patient who needs specialized care for mental health problems. Specifically, people with these types of disorders have a lower socioeconomic status and a greater tendency to smoke and be overweight. These findings are important for researchers, as these lifestyle habits increase the risk of developing other diseases, such as diabetes, hypertension, and disorders affecting the muscles and skeleton, which in turn can contribute to the development of cardiovascular disease or cancer. In their opinion, this demonstrates that mental health disorders exacerbate poverty and that those who suffer from them also have poorer physical health. At the same time, it provides professionals with tools to better address the needs of their patients, who require a comprehensive approach that goes beyond the disorder itself.