Concepts

Prescribing is not a measure of illness

23AI analysisDocumented

An idea drawn from this archive’s research and journal, either the author’s own speculation or generated by AI, and labelled as such.

It is tempting to read prescription volume as a thermometer for how ill a population is. The record does not support that, in either direction. In England, antidepressant items rose 50% in nine years while hypnotic and anxiolytic items FELL 16% over exactly the same period, from the same prescribers under the same system. In the United States, antipsychotic use among adults rose from 1.9% to 3.0%, while among children and adolescents it fell, 1.3% to 1.1%. And where a national registry lets diagnosis be counted directly, Denmark's new schizophrenia diagnoses went slightly down, 1.8 to 1.6 per 10,000, across eighteen years in which antipsychotic prescribing rose almost everywhere it was measured. Prescribing moves for its own reasons — guidance, capacity, recognition, duration of treatment, the licensing of new drugs, deliberate deprescribing campaigns. Sometimes it tracks illness. Here it demonstrably moves in opposite directions at once.

  • England FY2015/16 → FY2024/25: antidepressants 61.9M → 92.6M items (+50%)
  • Same period, opposite direction: hypnotics/anxiolytics 15.9M → 13.4M (−16%)
  • US 2006 → 2023: antipsychotic use, adults 1.9% → 3.0%; youth 1.3% → 1.1%
  • Denmark 2000 → 2018: new schizophrenia diagnoses 1.8 → 1.6 per 10,000

Open questions

  • Diagnosed depression in US adults did rise over a shorter window — 13.5% to 17.8% currently diagnosed, 2017–2023, self-reported. Whether that is more illness, more recognition, or more willingness to say so is not settled by this data.

References

Every figure above is a row in the Public Health indicator table, with its source.

Topics: Health & physical effects

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