Emotional problems and the use of psychotropic drugs: investigating racial inequality

Abstract The aim of the present study was to investigate the existence of racial inequalities in the prevalence of emotional problems, the search for healthcare services and the use of psychotropic drugs. A population-based, cross-sectional study was conducted with data from the 2014/15 Campinas Health Survey. Sample of 1953 individuals aged 20 years or older was analyzed. We estimated the prevalence of common mental disorders (CMDs), the reporting of emotional problems, insomnia, the search for and the use of healthcare services and the use of psychotropic drugs according to self-reported skin color (white and black/brown). Prevalence ratios were estimated using “Poisson” multiple regression. The prevalence of CMDs was higher among blacks/brown compared to whites but no difference was found regarding the reporting of emotional problems and insomnia. Whites sought healthcare services more due to emotional problems. The use of psychotropic drugs was also higher among whites. The results revealed racial inequalities in the presence of CMDs, the search for healthcare services and the use of psychotropics drugs, highlighting the need for actions to identify and overcome barriers that hinder access to mental health care by different racial segments of the population.

摘要 本研究旨在探讨情绪问题患病率、医疗服务寻求行为及精神药物使用方面的种族不平等现象。本研究基于2014/2015年坎皮纳斯健康调查（Campinas Health Survey）数据开展人群横断面研究，对1953名20岁及以上的个体样本进行分析。本研究根据受试者自我报告的肤色（白人、黑人/棕种人），估算了常见精神障碍（common mental disorders, CMDs）患病率、情绪问题报告率、失眠率、医疗服务寻求率及精神药物使用率。采用泊松（Poisson）多重回归模型估算患病率比。结果显示，黑人/棕种人群体的常见精神障碍患病率高于白人，但二者在情绪问题报告率与失眠率方面未发现显著差异；白人因情绪问题寻求医疗服务的比例更高，且精神药物使用率同样更高。本研究结果表明，在常见精神障碍患病、医疗服务寻求及精神药物使用方面均存在种族不平等现象，凸显出需采取相关措施以识别并消除不同种族群体获取精神卫生服务所面临的障碍。