An examination of the medicalization and pharmaceuticalization processes of anxiety and depressive disorders in Belgium between 2004 and 2013: how may both disorders be intertwined?

BACKGROUND: While medicalization and pharmaceuticalization trends of feelings of anxiety and depression have been described in great detail, an empirical examination of these trends is to date lacking. The current study fills this gap in the literature by mapping the use of psychotropic medicines for feelings of anxiety and depression between 2004 and 2013 in Belgium, as well as by examining whether a social gradient might act as a mediator. METHODS: We analyzed data from three repeated cross-sectional waves (2004, 2008, and 2013) of the Belgian National Health Interview Survey (HIS). Multinomial logistic regression was applied to estimate odds in psychotropic drugs use over the observed period. RESULTS: Using an ideal-typical distinction between traditional anxiety drugs (psycholeptics) and depression drugs (psychoanaleptics), we found that treatment methods for feelings of anxiety and depression were converging. Persons having feelings of anxiety consumed less psycholeptic drugs, in favor of psychoanaleptic drugs throughout the observed period. Moreover, these results were partially mediated by educational level. Persons with higher education were less likely to consume psychotropic drugs than those with lower education, suggesting a trend of demedicalization for feelings of anxiety and depression. LIMITATIONS: Our study observes a limited period, makes use of an ideal typical distinction between psycholeptic and psychoanaleptic drugs, and measurements may be biased by response-bias due to psychotropic drugs use. CONCLUSION: Our study shows that psycholeptics increasingly give way to psychoanaleptics in the treatment of both anxiety and depression, despite several scientists calling their effectiveness for both disorders into question.

An examination of the medicalization trend in female genital cutting in Egypt: How does it relate to a girl's risk of being cut?

Female Genital Cutting (FGC) is increasingly being performed by trained health professionals. International, national, and local institutions strongly oppose this medicalization trend, arguing that the involvement of health-care providers in the performance of FGC will counteract efforts to eliminate the practice. However, no empirical research to date has confirmed or refuted this claim. Therefore, it remains unclear how the medicalization of FGC relates to changes in the prevalence of the practice. In the current paper, we aim to fill this gap in the literature by examining the association between this medicalization trend and the risk of FGC. We focus on Egypt because of its high medicalization and prevalence rates and its unique history of FGC legislation. We performed a discrete-time event-history regression analysis combined with governorate fixed effects using the Egyptian Demographic Health Surveys from 2005, 2008, and 2014 (N = 49,273 daughters clustered within 29,810 mothers). Our results show that increasing medicalization rates coexist with decreasing prevalence rates. This effect is particularly pronounced in a context where a substantial number of cuts were medicalized (estimated at 40% and above). This effect is significantly more pronounced in higher educated mothers. Our study thus shows that the medicalization of FGC can coincide with decreasing prevalence rates of FGC. Medicalization of FGC may take place in a context where an awareness of the health hazards related to FGC is more pronounced, thereby also discouraging the practice as a whole. In addition, the medicalization of FGC may make the practice more individualized and therefore reduce the incentives for FGC.