An examination of the medicalization and pharmaceuticalization processes of anxiety and depressive disorders in Belgium between 2004 and 2013: how may both disorders be intertwined?

Kilian, Van Looy; de Velde Sarah, Van

doi:10.1186/s13690-022-00943-x

Archives of Public Health

Table 2 Multinomial logistic regression results for association between feelings of anxiety and depression, education and wave and the use of psycholeptics (outcome 1), psychoanaleptics (outcome 2), and both psycholeptics and psychoanaleptics (outcome 3), in reference to use of neither psycholeptics nor psychoanaleptics. Own calculations via the Belgian Health Interview Survey, 2004–2013

From: An examination of the medicalization and pharmaceuticalization processes of anxiety and depressive disorders in Belgium between 2004 and 2013: how may both disorders be intertwined?

	Outcome 1: use of psycholeptic medication (N05)
	Model 4			Model 5
Multinomial logistic regression results	OR	sig.	95% C.I.	OR	Sig.	95% C.I.
Intercept	0.003	***		0.003	***
Waves (ref. 2008)
2004	1.079		0.875, 1.331	1.340		0.428, 4.199
2013	0.591	***	0.465, 0.751	0.406		0.095, 1.736
Feelings of anxiety	2.124	***	1.671, 2.699	1.350		0.603, 3.019
Feelings of depression	1.597	***	1.283, 1.989	2.045		0.932, 4.489
Education (ref. no diploma)
Secondary school diploma	0.998		0.795, 1.253	0.585		0.204, 1.680
Higher education diploma	0.593	***	0.450, 0.782	0.260	*	0.070, 0.970
Wave (ref. 2008)*feelings of anxiety
2004*feelings of anxiety				4.327	**	1.447, 12.936
2013*feelings of anxiety				1.467		0.408, 5.276
Wave (ref. 2008)*feelings of depression
2004*feelings of depression				0.241	**	0.083, 0.698
2013*feelings of depression				0.813		0.227, 2.911
Wave (ref. 2008)* education (ref. no diploma)
2004*secondary education diploma				0.709		0.355, 5.607
2013*secondary education diploma				3.932		0.049, 1.325
2004*higher education diploma				2.635		0.069, 2.075
2013*higher education diploma				1.662		0.082, 4.416
Education (ref. no diploma)* feelings of anxiety
Secondary education diploma* feelings of anxiety				2.693	*	0.995, 7.289
Higher education diploma*feelings of anxiety				0.611		0.169, 2.208
Education (ref. no diploma)*feelings of depression
Secondary education diploma* feelings of depression				0.614		0.242, 1.560
Higher education diploma*feelings of depression				2.658		0.811, 8.714
Wave (ref. 2008)* education (ref. no diploma)*feelings of anxiety
2004secondary education diplomafeelings of anxiety				0.111	**	0.029, 0.429
2013secondary education diplomafeelings anxiety				0.338		0.074, 1.555
2004higher education diplomafeelings of anxiety				0.339		0.056, 2.073
2013higher education diplomafeelings of anxiety				2.732		0.411, 18.149
Wave (ref. 2008)education (ref. no diploma) feelings of depression
2004secondary education diplomafeelings of depression				8.017	**	2.256, 28.489
2013secondary education diplomafeelings of depression				1.343		0.307, 5.868
2004higher education diplomafeelings of depression				1.615		0.305, 8.539
2013higher education diplomafeelings of depression				0.294		0.048, 1.800
Gender (ref. male)	1.255	***	1.042, 1.512	1.257	*	1.042, 1.517
Age	1.055	*	1.001, 1.111	1.061	*	1.007, 1.118
Age²	1.000		1.000, 0.999	1.000		0.999, 1.000
	Outcome: use of psychoanaleptic medication (N06)
	Model 4			Model 5
Multinomial logistic regression results	OR	Sig.	95% C.I.	OR	Sig.	95% C.I.
Intercept	0.002	***		0.001	***
Waves (ref. 2008)
2004	1.001		0.773, 1.298	1.004		0.201, 5.027
2013	0.974		0.752, 1.261	1.422		0.227, 8.904
Feelings of anxiety	1.372	*	1.044, 1.804	1167		0.196, 2.137
Feelings of depression	2.037	***	1.599, 2.596	2.889		0.995, 7.742
Education (ref. no diploma)
Secondary school diploma	0.946		0.700, 1.278	0.451		0.106, 1.917
Higher education diploma	1.002		0.726, 1.383	0.226		0.046, 1.119
Wave (ref. 2008)*feelings of anxiety
2004*feelings of anxiety				1.828		0.380, 8.800
2013*feelings of anxiety				1.033		0.181, 5.890
Wave (ref. 2008)*feelings of depression
2004*feelings of depression				0.665		0.176, 2.519
2013*feelings of depression				0.785		0.169, 3.636
Wave (ref. 2008)* education (ref. no diploma)
2004*secondary education diploma				0.784		0.194, 8.391
2013*secondary education diploma				1.324		0.098, 5.802
2004*higher education diploma				2.899		0.045, 2.637
2013*higher education diploma				1.347		0.083, 6.662
Education (ref. no diploma)* feelings of anxiety
Secondary education diploma* feelings of anxiety				2.828		0.713, 11.217
Higher education diploma*feelings of anxiety				1.274		0.275, 5.914
Education (ref. no diploma)*feelings of depression
Secondary education diploma* feelings of depression				0.701		0.218, 2.252
Higher education diploma*feelings of depression				1.948		0.502, 7.565
Wave (ref. 2008)* education (ref. no diploma)*feelings of anxiety
2004secondary education diplomafeelings of anxiety				0.540		0.085, 3.427
2013secondary education diplomafeelings anxiety				0.918		0.128, 6.611
2004higher education diplomafeelings of anxiety				0.799		0.099, 6.456
2013higher education diplomafeelings of anxiety				2.109		0.253, 17.571
Wave (ref. 2008)education (ref. no diploma) feelings of depression
2004secondary education diplomafeelings of depression				1.496		0.308, 7.274
2013secondary education diplomafeelings of depression				0.859		0.152, 4.862
2004higher education diplomafeelings of depression				0.639		0.103, 3.976
2013higher education diplomafeelings of depression				0.455		0.069, 2.996
Gender (ref. male)	1.508	***	1.219, 1.865	1.518	***	1.225, 1.880
Age	1.138	***	1.074, 1.206	1.143	***	1.078, 1.212
Age²	0.999	***	0.998, 0.999	0.999	***	0.998, 0.999
	Outcome 3: use of both psycholeptic and psychoanaleptic medication (N05 + N06)
	Model 4			Model 5
Multinomial logistic regression results	OR	sig.	95% C.I.	OR	Sig.	95% C.I.
Intercept	0.00002	***		0.00002	***
Waves (ref. 2008)
2004	1.043		0.789, 1.377	1.595		0.319, 7.974
2013	0.567	***	0.418, 0.770	1.518		0.254, 9.080
Feelings of anxiety	1.918	***	1.467, 2.509	1.314		0.492, 3.507
Feelings of depression	2.532	***	1.980, 3.238	2.816	*	1.065, 7.444
Education (ref. no diploma)
Secondary school diploma	1.072		0.790, 1.454	0.910		0.207, 3.996
Higher education diploma	0.714		0.495, 1.030	0.327		0.059, 1.815
Wave (ref. 2008)*feelings of anxiety
2004*feelings of anxiety				1.457		0.380, 5.579
2013*feelings of anxiety				1.063		0.262, 4.311
Wave (ref. 2008)*feelings of depression
2004*feelings of depression				0.650		0.185, 2.290
2013*feelings of depression				0.803		0.200, 3.229
Wave (ref. 2008)* education (ref. no diploma)
2004*secondary education diploma				0.307		0.495, 21.361
2013*secondary education diploma				0.563		0.229, 13.782
2004*higher education diploma				1.250		0.090, 7.070
2013*higher education diploma				0.454		0.188, 25.711
Education (ref. no diploma)* feelings of anxiety
Secondary education diploma* feelings of anxiety				3.067		0.932, 10.086
Higher education diploma*feelings of anxiety				0.621		0.154, 2.502
Education (ref. no diploma)*feelings of depression
Secondary education diploma* feelings of depression				0.496		0.160, 1.540
Higher education diploma*feelings of depression				3.158		0.830, 12.009
Wave (ref. 2008)* education (ref. no diploma)*feelings of anxiety
2004secondary education diplomafeelings of anxiety				0.379		0.076, 1.899,
2013secondary education diplomafeelings anxiety				0.508		0.094, 2.741
2004higher education diplomafeelings of anxiety				1.298		0.174, 9.694
2013higher education diplomafeelings of anxiety				1.347		0.191, 9.485
Wave (ref. 2008)education (ref. no diploma) feelings of depression
2004secondary education diplomafeelings of depression				3.709		0.836, 16.455
2013secondary education diplomafeelings of depression				1.637		0.319, 8.404
2004higher education diplomafeelings of depression				0.534		0.082, 3.470
2013higher education diplomafeelings of depression				0.604		0.096, 3.799
Gender (ref. male)	2.094	***	1.647, 2.663	2.130	***	1.671, 2.716
Age	1.213	***	1.125, 1.308	1.225	***	1.135, 1.322
Age²	0.998	***	0.998, 0.999	0.998	***	0.998, 0.999
Nagelkerke R-squared	0.196			0.211
Loglikelihood	981.285	***		1063.395	***

* p < 0.05 ** p < 0.01 *** p < 0.001; n = 7214

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