[Dealing with current disability pension cases].
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Biomedical subjects
Publications and source records attributed to G Tellnes.
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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.
In an island community in Northern-Norway 18.7% of the population received one or more prescriptions of psychotropic drugs during a three-year period. This is the first of two articles that describe the general practitioner's prescribing of psychotropic drugs in this municipality. This article compares the psychotropic drug-users and non-users in order to identify and define the characteristics of local risk groups. Socio-demographic data and use of health services are analysed. The aim is to get a baseline for prevention of mental problems in the local community. The study indicates that high risk groups regarding psychotropic drug-use in this defined community were men greater than or equal to 65 years, females greater than or equal to 45 years, previously married/unmarried, disabled pensioners, young wives (25-44 years) with fulltime occupation outside the home, and middle-aged wives (45-64 years) without fulltime occupation outside the home. Thus suggestions and advice for prevention of mental problems can be listed and presented for local authorities, which by law are responsible for prevention of diseases.
In a rural community in the northern part of Norway, the prescribing of psychotropic drugs has been recorded. The total prescribing during three years amounted to 60 defined daily doses per thousand inhabitants per day. Hypnotics and sedatives comprised together with antihistamines, 50% of the total amount of defined daily doses. Neurosis was the dominating indication for prescribing. The majority of the patients (59%) received less than 50 defined daily doses per year, indicating that most patients have a moderate consumption of psychotropic drugs. One of five users were prescribed more than 180 defined daily doses per year (71% of all DDD), representing a probable risk-group for chronic use.
When the community diagnosis was described for two islands, Vaerøy and Røst, in 1970-73 injuries were found to be the most common single diagnosis. During one year (1979-80) all the injured patients who contacted the district physician in the municipality of Vaerøy were recorded in order to study the aetiology of injuries. Based on the experience from this study, an injury prevention programme was designed for this local community. The campaign started in 1981. A follow-up study in 1981-83 evaluated the effect of the prevention campaign. Two years after the programme started, the occurrence of injuries had declined by 29 per cent.
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