Treatment of mental problems in general practice. A one year prospective study from an island community in northern...

The aim of the study was to provide a basis for improving the treatment and prevention of mental problems in a defined local community. The prescribing of psychotropic drugs has been recorded as well as the use of non-drug therapy and the factors which worsened the patients' mental problems. The rate of psychotropic drug-users was 15% for females and 9% for males. The total prescribing during one year amounted to 59 defined daily doses (DDD) per thousand inhabitants per day. Hypnotics/sedatives constituted 30%, anti-histamines 23%, neuroleptics 18%, minor tranquillizers 16%, and antidepressants 13%. About 1/4 of the psychotropic drug-users was prescribed more than 180 DDD per year, representing a risk group for chronic use. The majority of all psychotropic drugs (65%) was prescribed through indirect contacts implying a danger of developing "repeat prescription syndromes". Less than one half of the patients who might have benefited from referral to a psychiatrist had, in fact, been referred during the previous three years. Somatic disease (among the psychotropic drug-users) and illness among other family members were frequently reported as worsening factors. This indicates the importance of holistic therapy and prophylaxis in general practice. Among our advice for prevention of mental problems to the local authorities was the arrangement of weekly social meetings and clubs for disabled pensioners and elderly people.