Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 35

ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS ■
S-X/4 Thursday 14/8,11:00-12:30
Well-being and work satisfaction among lcelandic hospital
doctors
Kristinn Tómasson, MD, Dr. Med., Dept. of Research & Occupational Health, Admini-
stration for Occupational Health & Safety, Bfldshöföa 16,110 Reykjavík, Iceland. Hauk-
ur Hjaltason, Ólöf Sigurðardóttir, Þorsteinn Blöndal, Höröur Alfreðsson, Jón Högnason.
khstinn@ver.is
Objeclive: To study the work environment of medical doctors
working at the National University Hospital in Reykjavík with
special emphasis on the psychosocial work environment and
differences related to positions.
Methods: In collaboration witli the medical council of the hospital
and the Administration for Occupational Health and Safety a ques-
tionnaire was created that was subsequently sent out to 581
physicians working at the hospital. The questionnaire was returned
by 78% of the adnrinistrating (AP), 58% of regular staff (RSP) and
47% of resident physicians (R).
Results: Too much work pressure was perceived equally by the 3
different groups or about 14%, while 69% of the AP compared with
29% 0f the RSP, and only 11 % of the R. took their work with them
home more than 2 a week. Similar percentage in each group per-
ceived that they were receiving support fronr their supervisors, but
the R, and RSP complaint significantly more often about poor flow
of information, poor work moral, lack of possibilities to influence
the work, and dissatisfaction with the hospital management in
general. Satisfaction with work and mental well-being was signifi-
cantly better among the AP than among the other two groups.
Conclusions: Special effort is needed to improve psychosocial work
environment for all physicians, but in particular for regular staff and
resident physician.
S-XI/1 Friday 15/8,11:00-12:30
Antidepressants and public health
Tómas Zoega, Chief Psychiatrist, National University Hospital of Iceland, Department
°f Psychiatry, 101 Reykjavík, Iceland. Helgi Tómasson, Tómas Helgason.
tomasz @landspitali. is
Background: Major depressive disorder is the second leading cause
of disability adjusted life years in developed regions of the world
and antidepressants are the third ranked therapy class worldwide.
Antidepressants are also used for anxiety disorders.
Aini: To test the public health impact of the escalating sales of anti-
depressants.
Methods: Nation-wide data from Iceland are used as an example to
study the effect of sales of antidepressants on suicides, disability,
hospital admissions and outpatient visits.
Results: Sales of antidepressants increased from 8.4 Daily Defined
Doses /1000/day in 1975 to 72.7 in 2000, a user prevalence of 8.7 %
for the adult population. Suicide rates fluctuated during 1950-2000,
but did not show any definite trend. Rates for outpatient visits in-
creased slightly over the period 1989-2000, admission rates in-
creased even more. Prevalence of disability due to depressive and
anxious disorders has not decreased over the last 25 years.
Conclusions: The dramatic increase in the sales of antidepressants
has not had any marked impact on the selected public health mea-
sures. Obviously, better treatment for depressive disorders is still
needed in order to reduce the burden caused by them.
S-XI/2 Friday 15/8,11:00-12:30
Epidemiology of antidepressant use in lceland
Kristinn Tómassnn, MD, Dr. Med, Dept. of Research & Occupational Health,
Administration for Occupational Health & Safety, Bfldshöföa 16, 110 Reykjavík,
Iceland. Tómas Zoega, Eggert Sigfússon,Tómas Helgason.
kristinn@ver.is
Background: Sales of antidepressants have increased almost six
fold in Iceland during the last 15 years.
Aim: To study the prevalence of antidepressants’ usage, and to
compare it with national prescription data.
Material and methods: Data was collected in 2001 by a postal and
telephone survey of a random sample of the population aged 18-75
years, 4000 individuals. Anonymous prescription data was obtained
from the State Social Security Institute.
Rcsults: The response rate in the survey was 63.6%. The one-year
prevalence of antidepressant use was 8.3%, slightly higher for
women than men, similar in all age groups. One half of the youngest
age group used antidepressants for less than three months. Smokers
and people with limited education and low income were most likely
to have used antidepressants. People aged 18-75 years filled pre-
scriptions for 95.2 DDD/1000/Day increasing frorn 45 among the
18-24 year old to 134 among those 65-75 years old. The quantity
filled for women was almost twice as much as for men.
Conclusions: Sex difference was smaller in the community survey
than according to the prescription data. Prescriptions filled and
long-term use increased with age. As expected the use was most
common among the socio-economically disadvantaged.
S-XI/3 Friday 15/8,11:00-12:30
The antidepressant debate: How to identify patients
benefiting from antidepressants is the key question
Ulrik Fredrik Malt, Dept. of Psychosomatic and Neurobehavioural Medicine, Riks-
hospitalet, University of Oslo, NO-0027 Oslo, Norway
u.f.malt@psykialri.uio.no
Studies of the efficacy of antidepressants compared to psychothe-
rapy among outpatients often suggest equal effects. However, not
all studies support this view. In the largest prinrary care randomised
controlled study until to day NOT applying placebo responder ex-
clusion prior to the study, 372 patients were treated for 24 weeks.
All patients received a combination of a simple problem solving
and supportive therapy (PSST). In addition, the patients received
placebo or active medication (mianserin, sertraline). The overall
results favoured the PSST+active drug combination. Interestingly,
the difference in effect size between the PSST-active drug combina-
tion compared to PSST-placebo combination was largest anrong
MADRS-items reflecting core depressive symptoms, thus suppor-
ting a true effect of adding active drug.
However, secondary analyses showed that the severity of the
depressive episode and the presence of previous depressive epi-
LÆKNABLAÐIÐ / FYLGIRIT 48 2003/89 35