Gender differences in psychotropic medication prescribing in a rural area of Catalonia: a community-based...

Gender disparities in the diagnosis and treatment of common mental disorders are well documented, with women more frequently prescribed psychotropic medications than men. However, evidence from rural settings remains scarce. This study examined gender differences in psychotropic medication prescriptions among adults with mental health diagnoses in a rural region of Catalonia, Spain.

A retrospective, population-based study was conducted using data from the primary care database. Adults with at least one diagnosis of anxiety, depression, mood disorder, sleep disorder, stress, or distress were included. Prescription patterns of psychotropic medications were analyzed by sex and age group using descriptive statistics, Chi-square tests, and multivariable logistic regression adjusted for age, number of prescribed medications, and diagnosis.

Among 32,748 individuals, 64.9% were women. Women were more frequently diagnosed with depression (27.4 vs. 22.5%), anxiety (57.1 vs. 53.5%), and mood disorders (4.2 vs. 2.8%; all p < 0.001), while sleep disorders were more common in men (34.9 vs. 32.3%, p < 0.001). Women were more likely to be prescribed anxiolytics (40.2 vs. 32.8%) and antidepressants (35.5 vs. 23.9%). Logistic regression confirmed higher odds of antidepressant (aOR = 1.52; 95% CI: 1.43-1.60) and anxiolytic use (aOR = 1.29; 95% CI: 1.22-1.36) among women, and lower odds for antipsychotics (aOR = 0.68; 95% CI: 0.61-0.76). Disparities were most pronounced among women aged 45-64 years.

Women in rural Catalonia were more often diagnosed with mental disorders and prescribed psychotropic medications, particularly antidepressants and anxiolytics. A gender-sensitive approach in primary care, including expanded access to psychological therapies and community-based services, is needed to address inequities.