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Anxiolytic Medication Use in Low‐ Middle‐ and High‐Income Countries: A World Mental Health Surveys Report

Title: Anxiolytic Medication Use in Low‐ Middle‐ and High‐Income Countries: A World Mental Health Surveys Report
Authors: Stein, Dan; Kazdin, Alan; Baldwin, David; Harris, Meredith; Hwang, Irving; Pozuelo, Julia; Sampson, Nancy; Woodruff, Peter; Viana, Maria Carmen; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Alonso, Jordi; Andrade, Laura Helena; Benjet, Corina; Bruffaerts, Ronny; Caldas-De-Almeida, José‐miguel; Chardoul, Stephanie; de Girolamo, Giovanni; Gureje, Oye; Haro, Josep; Karam, Elie; Karam, Aimee; Kovess-Masfety, Viviane; Navarro-Mateu, Fernando; Nishi, Daisuke; Posada-Villa, José; Roest, Annelieke; Stagnaro, Juan Carlos; Vladescu, Cristian; Vigo, Daniel; Kessler, Ronald
Contributors: South African Medical Research Council Cape Town, South Africa (SAMRC); Department of Psychology, Yale University, New Haven, CT; Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK.; The University of Queensland, Faculty of Medicine, School of Public Health, Herston, Qld 4006, Australia.; Queensland Centre for Mental Health Research; Harvard Medical School Boston (HMS); Department of Psychiatry, University of Oxford; School of Medicine and Population Health, University of Sheffield; Federal University of Espírito Santo, UFES, Vitória, Brazil.; UC Davis Health System, Sacramento, California; College of Medicine, Al-Qadisiya University, Diwaniya Governorate, Diwaniya, Iraq; Hospital del Mar Medical Research Institute (IMIM); Universitat Pompeu Fabra Barcelona (UPF); Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health (CIBERESP); Faculdade de Medicina Universidade de São Paulo (FMUSP); Universidade de São Paulo = University of São Paulo (USP); National Institute of Psychiatry Ramón de la Fuente Muñiz Mexico City (INPRF); Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium; Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.; Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia; University College Hospital, Ibadan, Nigeria.; Centro de Investigación Biomédica en Red Salud Mental Madrid (CIBER-SAM); Department of Psychiatry and Clinical Psychology, Faculty of Medicine, St George University of Beirut, Beirut, Lebanon; Université de Rennes (UR); École des Hautes Études en Santé Publique (EHESP); Département Méthodes quantitatives en santé publique (METIS); Laboratoire de Psychopathologie et Processus de Santé (LPPS - EA 4057); Université Paris Descartes - Paris 5 (UPD5); Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud. Murcia. Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid. Spain; IMIB-Arrixaca. Murcia, Spain; Biomedical Research Institute of Murcia Pascual Parrilla-IMIB, Murcia, Spain; Consejería de Sanidad de Murcia, Ciber de Epidemiologia y Salud Pública (CIBERESP); Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia; Department of Developmental Psychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands; Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina; National Institute for Health Services Management, Bucharest, Romania; Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; The World Health Organization World Mental Health (WMH) SurveyInitiative is supported by the United States National Institute of MentalHealth (NIMH; R01 MH070884), the John D. and Catherine T. Mac-Arthur Foundation, the Pfizer Foundation, the United States PublicHealth Service (R13‐MH066849, R01‐MH069864, and R01 DA016558),the Fogarty International Center (FIRCA R03‐TW006481), the PanAmerican Health Organization, Eli Lilly and Company, Ortho‐McNeilPharmaceutical Inc., GlaxoSmithKline, and Bristol‐Myers Squibb. Wethank the staff of the WMH Data Collection and Data Analysis Coordi-nation Centers for assistance with instrumentation, fieldwork, andconsultation on data analysis. None of the funders had any role in thedesign, analysis, interpretation of results, or preparation of this paper.The views and opinions expressed in this report are those of the authorsand should not be construed to represent the views of the World HealthOrganization, other sponsoring organizations, agencies, or governments.The Argentina survey − Estudio Argentino de Epidemiología en SaludMental (EASM) − was supported by a grant from the Argentinian Ministryof Health (Ministerio de Salud de la Nación) − (Grant 2002–17270/13–5).The São Paulo Megacity Mental Health Survey is supported by the State ofSão Paulo Research Foundation (FAPESP) Thematic Project Grant 03/00,204–3. The Bulgarian Epidemiological Study of common mental dis-orders EPIBUL is supported by the Ministry of Health and the NationalCenter for Public Health Protection. The Colombian National Study ofMental Health (NSMH) is supported by the Ministry of Social Protection.The Mental Health Study Medellín—Colombia was carried out and sup-ported jointly by the Center for Excellence on Research in Mental Health(CES University) and the Secretary of Health of Medellín. The ESEMeDproject is funded by the European Commission (Contracts QLG5‐1999–01042; SANCO 2004123, and EAHC 20,081,308), the Piedmont Region (Italy), Fondo de Investigación Sanitaria, Instituto de Salud CarlosIII, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF2000–158‐CE), Generalitat de Catalunya (2017 SGR 452; 2014 SGR 748),Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011REM‐TAP), and other local agencies and by an unrestricted educationalgrant from GlaxoSmithKline. Implementation of the Iraq Mental HealthSurvey (IMHS) and data entry were carried out by the staff of the IraqiMOH and MOP with direct support from the Iraqi IMHS team withfunding from both the Japanese and European Funds through UnitedNations Development Group Iraq Trust Fund (UNDG ITF). The IsraelNational Health Survey is funded by the Ministry of Health with supportfrom the Israel National Institute for Health Policy and Health ServicesResearch and the National Insurance Institute of Israel. The World MentalHealth Japan (WMHJ) Survey is supported by the Grant for Research onPsychiatric and Neurological Diseases and Mental Health (H13‐SHOGAI‐023, H14‐TOKUBETSU‐026, H16‐KOKORO‐013, H25‐SEISHIN‐IPPAN‐006) from the Japan Ministry of Health, Labour and Welfare. The Leb-anese Evaluation of the Burden of Ailments and Needs of the Nation (L.E.B.A.N.O.N.) is supported by the Lebanese Ministry of Public Health, theWHO (Lebanon), National Institute of Health/Fogarty InternationalCenter (R03 TW006481‐01), anonymous private donations to IDRAAC,Lebanon, and unrestricted grants from, Algorithm, AstraZeneca, Benta,Bella Pharma, Eli Lilly, Glaxo Smith Kline, Lundbeck, Novartis, Omni-Pharma, Pfizer, Phenicia, Servier, and UPO. The Mexican National Co-morbidity Survey (MNCS) is supported by The National Institute ofPsychiatry Ramon de la Fuente (INPRFMDIES 4280) and by the NationalCouncil on Science and Technology (CONACyT‐G30544‐H), with sup-plemental support from the Pan American Health Organization (PAHO).The Nigerian Survey of Mental Health and Wellbeing (NSMHW) is sup-ported by the WHO (Geneva), the WHO (Nigeria), and the Federal Min-istry of Health, Abuja, Nigeria. The Peruvian World Mental Health Studywas funded by the National Institute of Health of the Ministry of Health ofPeru. The Portuguese Mental Health Study was carried out by theDepartment of Mental Health, Faculty of Medical Sciences, NOVA Uni-versity of Lisbon, with collaboration of the Portuguese Catholic Univer-sity, and was funded by Champalimaud Foundation, GulbenkianFoundation, Foundation for Science and Technology (FCT) and Ministryof Health. The Romania WMH study projects “Policies in Mental HealthArea” and “National Study regarding Mental Health and Services Use”were carried out by National School of Public Health & Health ServicesManagement (former National Institute for Research & Development inHealth), with technical support of Metro Media Transilvania, the NationalInstitute of Statistics‐National Center for Training in Statistics, SCCheyenne Services SRL, Statistics Netherlands and were funded byMinistry of Public Health (former Ministry of Health) with supplementalsupport of Eli Lilly Romania SRL. The Psychiatric Enquiry to GeneralPopulation in Southeast Spain—Murcia (PEGASUS‐Murcia) Project hasbeen financed by the Regional Health Authorities of Murcia (ServicioMurciano de Salud and Consejería de Sanidad y Política Social) andFundación para la Formación e Investigación Sanitarias (FFIS) of Murcia.US National Comorbidity Survey Replication (NCS‐R) is supported by theNational Institute of Mental Health (NIMH; U01‐MH60220) with sup-plemental support from the National Institute of Drug Abuse (NIDA), theSubstance Abuse and Mental Health Services Anxiolytic medi-cationinistration (SAMHSA), the Robert Wood Johnson Foundation(RWJF; Grant 044,708), and the John W. Alden Trust. Dr. Laura HelenaAndrade is supported by the Brazilian Council for Scientific and Tech-nological Development (CNPq Grant # 307933/2019–9).; Collaboration internationale
Source: ISSN: 0885-6222 ; EISSN: 1099-1077.
Publisher Information: CCSD; Wiley
Publication Year: 2026
Subject Terms: reasons for use; perceived effectiveness; anxiolytic medications; [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie; [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health
Description: International audience ; ABSTRACT Background Anxiolytic medications, particularly benzodiazepines, are widely prescribed, giving impetus to long‐standing debates about how often these agents should be employed in clinical practice. There are, however, few cross‐country studies of the pharmacoepidemiology of these agents. We report on the frequency of anxiolytic medication use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries. Methods Face‐to‐face interviews with community samples totaling n = 49,919 respondents in the World Health Organization World Mental Health (WMH) Surveys asked about anxiolytic medication use anytime in the prior 12 months in conjunction with validated fully structured diagnostic interviews. Treatment questions were administered independently of diagnoses to all respondents. Results A weighted 5.6% ( n = 4079) of respondents reported anxiolytic medication use within the past 12 months; the vast majority comprised benzodiazepine use, and use was highest amongst respondents with a subthreshold major depressive episode (MDE) (25.2%) and a 12‐month MDE (19.8%). Rates were significantly higher in high‐income countries (HICs) than low‐ and middle‐income countries (LMICs) (8.5% vs. 2.2%, χ 2 1 = 559.6, p < 0.001). Short‐acting benzodiazepines and z‐drugs were most commonly used for sleep (66.5% and 85.5%), while intermediate‐acting benzodiazepines and long‐acting benzodiazepines were most commonly used either for sleep (37.9% and 30.1%) or anxiety (33.3% and 32.0%). Across all conditions, anxiolytic medications were reported as very effective by 55.7% of users and somewhat effective by an additional 32.2% of users, with similar proportions in HICs and LMICs. Negative predictors of high perceived effectiveness were a 12‐month MDE and taking anxiolytic medication for comorbid anxiety and depression. Conclusion These data do not definitely answer the question of how often benzodiazepines should be prescribed in clinical practice, but they ...
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/41474294; PUBMED: 41474294; PUBMEDCENTRAL: PMC12755120
DOI: 10.1002/hup.70031
Availability: https://ehesp.hal.science/hal-05472964; https://doi.org/10.1002/hup.70031
Accession Number: edsbas.959EE5D2
Database: BASE