The British Journal of Psychiatry (2008) 193: 235-239. doi: 10.1192/bjp.bp.107.038299
© 2008 The Royal College of Psychiatrists
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Ethnic density, physical illness, social deprivation and antidepressant prescribing in primary care: ecological study

Paul Walters, MSc, MRCPsych

Section of Primary Care Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King’s College London

Mark Ashworth, DM, MRCP, MRCGP

Department of General Practice & Primary Care, King’s College London School of Medicine, London

André Tylee, MD, FRCGP, MRCPsych

NIHR Biomedical Research Centre for Mental Health, and South London & Maudsley NHS Foundation Trust, and Section of Primary Care Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King’s College London, UK.

Correspondence: Paul Walters, Section of Primary Care Mental Health, Box 028, Health Service and Population Research Department, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. Email: p.walters{at}iop.kcl.ac.uk

Declaration of interest

A.T. and P.W. have received speaker fees and symposia fees from several companies including Lilly, Servier and Lundbeck. A.T. has received research funds from several companies.

Background

Antidepressant prescribing should reflect need. The Quality and Outcomes Framework has provided an opportunity to explore factors affecting antidepressant prescribing in UK general practice.

Aims

To explore the relationship between physical illness, social deprivation, ethnicity, practice characteristics and the volume of antidepressants prescribed in primary care.

Method

This was an ecological study using data derived from the Quality and Outcomes Framework, the Informatics Collaboratory of the Social Sciences, and Prescribing Analyses and CosT data for 2004–2005. Associations were examined using linear regression modelling.

Results

Socio-economic status, ethnic density, asthma, chronic obstructive pulmonary disease and epilepsy explained 44% of the variance in the volume of antidepressants prescribed.

Conclusions

Lower volumes of antidepressants are prescribed in areas with high densities of Black or Asian people. This may suggest disparities in provision of care. Chronic respiratory disease and epilepsy may have a more important association with depression in primary care than previously thought.