In 2018, 12% of the population reported the use of sleeping pills or tranquilizers in the last 2 weeks, and 8% reported recent use of antidepressants. The consumption of sleeping pills or tranquilizers started to decrease in 2008, while the consumption of antidepressants continued to increase.
Consumption of psychotropic medicines was more frequent in the lowest educated group compared to the highest educated group.
2.Background
In Belgium, the Health Interview Survey is one of the main sources of systematic data on mental health indicators in the general population. It namely monitors the self-reported use of sedatives (sleeping pills or tranquilizers) and antidepressants in Belgium since 1997. For the sedatives, the Health Interview Survey is the only available data source, since those drugs are not reimbursed and therefore, do not figure in the health insurance data.
The use of psychotropic drugs is measured during the last 2 weeks in people aged 15 and over.
3.Consumption of psychotropic medicines
Situation in 2018
Belgium
In 2018, 12.3% of the population used sedatives (sleeping pills or tranquilizers) and 7.6% used antidepressants in the past 2 weeks. More women than men consumed sedatives (15% in women vs 9.5% in men) and antidepressants (9.8% vs 5.3%).
The consumption of sedatives increased with age, particularly after 45 years in women and after 65 years in men.
The consumption of antidepressants is particularly high in women after 45 years of age.
In 2018, the consumption of sedatives is slightly higher in Wallonia and in Flanders than in Brussels, but the regional differences are narrow and not significant.
The consumption of antidepressants is slightly lower in Flanders than in the other regions, but the differences are only significant in women.
Trends
Belgium
From 1997 to 2008, the consumption of sedatives in the population increased, then it decreased in 2013 and in 2018 when considering both genders together. In men the consumption remained stable round 10%, while it decreased from 19% in 2008 to 15% in 2018 in women.
Since 1997, the consumption of antidepressants has doubled in both genders.
Regional specificities
The consumption of sedatives used to be significantly lower in Flanders than in the 2 other regions until 2008 in both genders. After 2008, as the use of sedatives continued to increase in Flanders while slightly decreasing in the other regions, the regional differences narrowed and quasi disappeared by 2018.
There was a socio-economic gradient in the consumption of sedatives and antidepressants. A higher proportion of people from the lowest educational group consumed sedatives (17.7% vs 12.3%) and antidepressants (10.3% vs 6%) than from the highest educational group.
Consumption of sleeping pills or tranquilizers and antidepressants, by educational level, Belgium, 2018 Source: Own calculations based on Health Interview Survey, Sciensano, 2018 [1]
The crises that our society has been going through since the start of the pandemic in 2020 are affecting a large number of people.
While around one person in ten had anxiety and/or depressive disorders in 2018, these disorders affected almost one person in four at the time of the peaks in contamination and the strengthening of measures.
Some people are affected more than others, such as women, young people, and people in precarious situations.
2.The prevalence of anxiety and depression from 2020 onwards
During the COVID-19 crisis, there was a significant rise in anxiety disorders and depressive disorders, particularly during peaks in contamination and the introduction of strict measures. In December 2020, 23% of the population suffered from anxiety disorders and 22% from depressive disorders.
Although a decrease has been observed in 2022, with anxiety and depressive disorders affecting 15% to 19% and 13% to 17% of the population respectively, depending on the month considered; these figures are still higher than those for 2018, when 11% of the population suffered from anxiety disorders and 9% from depressive disorders. It should be noted that in 2022, despite the announcement of the end of the COVID-19 crisis, other major crises emerged, such as the war in Ukraine and its economic consequences.
The data collected from 2023 onwards indicate a gradual decline in these problems among the population. In June 2023, 15% and 12% of people had anxiety and depressive disorders respectively.
Percentage of the population aged 18 and over presenting anxiety or depressive disorders in the COVID-19 health surveys 2020-2023 compared to the health interview survey 2018, Belgium, 2023 Source: COVID-19 health surveys and HIS 2018, Sciensano [1,3-11]
In Belgium, the groups most at risk of developing anxiety and depression disorders include women, young adults aged between 18 and 29, people with lower education, people living alone with children, and residents of Wallonia.
In June 2023, young women aged 18 to 29 are more likely to present signs of anxiety disorders (25%) than young men (16%). Men aged 18-29 are more likely to develop depression than the opposite sex of the same age (21% and 14% respectively). The prevalence of anxiety and depressive disorders is higher in young people (18-29) than in people aged 65 years and older. Signs of anxiety are present in 20% of young people (18-29) and 7% of people aged 65 years and older, and signs of depression are observed in 17% of young people (18-29) and 6% of people aged 65 years and older.
3.The prevalence of anxiety and depression in 2018
Women present more often an anxiety and depressive disorder compared to men
Based on these psychometrics questionnaires, in 2018, 11.2% of the Belgian population aged 15 and over presented an anxiety disorder and 9.4% presented a depressive disorder. For both disorders, women had a higher prevalence (14.2% for anxiety and 10.7% for depression) than men (7.9% for anxiety and 8% for depression).
The trend shows that anxiety remains high over time, while depression returns to its pre-2013 level
The prevalence of anxiety disorders increased among people of both sexes in 2013 compared with previous years, and this increase was maintained in 2018.
The prevalence of depressive disorders also increased in 2013 among people of both sexes. Subsequently, in 2018, the pre-2013 figures were repeated, with a clearer drop among women than among men between these two years. It should be noted, however, that the questionnaires used to assess the presence of anxiety and depression were different in 2018 than in previous surveys. Consequently, trends should be interpreted with caution.
The Walloon Region and the Brussels-Capital Region have a higher prevalence compared to the Flemish Region
The Walloon Region had a higher prevalence of anxiety and depressive disorders compared to the Brussels Capital Region and the Flemish Region and the Brussels Capital Region had a higher prevalence compared to the Flemish Region.
Between 2008 and 2013, the prevalence of anxiety disorders increased in all regions. Between 2013 and 2018, it continued to rise in the Walloon region, especially among women but also among men, whereas this was not the case in the other regions.
Depressive disorders have been less frequent in the Flemish Region than in the Brussels-Capital Region and the Walloon Region among women since measurements began in 2001, and among men since 2008.
Men
Women
Prevalence of anxiety disorders in men in Belgium and its regions, 2001-2018b b break in series, change of instrument Source: Own calculations based on Health Interview Survey, Sciensano, 2001-2018 [11]
Prevalence of anxiety disorders in women in Belgium and its regions, 2001-2018b b break in series, change of instrument Source: Own calculations based on Health Interview Survey, Sciensano, 2001-2018 [11]
Men
Women
Prevalence of depressive disorders in men in Belgium and its regions, 2001-2018b b break in series, change of instrument Source: Own calculations based on Health Interview Survey, Sciensano, 2001-2018 [11]
Prevalence of depressive disorders in women in Belgium and its regions, 2001-2018b b break in series, change of instrument Source: Own calculations based on Health Interview Survey, Sciensano, 2001-2018 [11]
People in the lowest educational group were more likely to present an anxiety or depressive disorder
There is a strong socio-economic gradient in the prevalence of mental health disorders. After age-adjustment, anxiety disorders were 2.3 times more frequent in people from the lowest educational group compared to the highest educational group. Depressive disorders were 3 times more frequent in people from the lowest educational group compared to the highest educational group.
If you are in distress or in need of emotional/psychological support, do not hesitate to call 02 648 40 14 for the community help service helpline, or visit the Community Help Service online.
Background
Mental health is the capacity of each of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections, and personal dignity [12]. Due to the high frequency of mental problems in Western societies and the significance of their costs in human, social, and economic terms, mental health is now regarded as a public health priority. Mental health particularly deteriorated during the COVID-19 crisis.
In Belgium, the Health Interview Survey is one of the main sources of systematic data on mental health parameters in the general population. During the COVID-19 crisis, regular online health surveys were organized at regular time intervals to follow the evolution of the mental health of the population.
Among the various dimensions of mental health that are monitored in this survey, we focus on the following two disorders:
However, it should be noted that the evaluation of mental health problems in the population through a health survey has a number of limitations. These are mainly related to the fact that the estimates are based on screening instruments for psychological problems and thus are not obtained by clinical diagnostic tools, which may be more nuanced. Nevertheless, the results of general population health surveys are generally in line with the findings of specific mental health surveys.
More serious mental health disorders like schizophrenia and bipolar disorders are not presented here. Indeed, health interview surveys are not a valid instrument to capture such complex conditions. Moreover, information about suicidal behaviours can be found on a specific page.
Definitions
GAD-7: General Anxiety Disorder 7-item
The GAD-7 is a screening tool for general anxiety disorder. Participants aged 15 and over are asked to evaluate the frequency, if ever, of experiencing 7 core symptoms in the last 2 weeks. The scores obtained allow to evaluate the symptom severity.
Anxiety disorders
Participants aged 15 and over with a score of 10 or over out of 21 in the GAD-7 tool were considered to have an anxiety disorder.
PHQ-9: Patient Health Questionnaire 9-item depression scale
The PHQ-9 is a screening tool for major depressive disorder and other depressive disorders. Participants aged 15 and over are asked to evaluate the frequency in which they have been bothered by 9 problems in the last 2 weeks.
Depressive disorders
Participants aged 15 and over with a combination of answers meeting the criteria specific for major depressive disorder and other depressive disorders for the PHQ-9 were considered to have a depressive disorder.
References
Première enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2020/14.440/50. Brussels: Sciensano; 2020. doi: 10.25608/ydnc-dk63
Deuxième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2020/14.440/52. Brussels: Sciensano; 2020. doi: 10.25608/rkna-ee65
Troisième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2020/14.440/54. Brussels: Sciensano; 2020. doi: 10.25608/xkg3-xz50
Quatrième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2020/14.440/80. Brussels: Sciensano; 2020. doi: 10.25608/jmgf-2028
Cinquième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2020/14.440/96. Brussels: Sciensano; 2020. doi: 10.25608/xcxd-7784
Sixième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2021/14.440/30. Brussels: Sciensano; 2021. doi: 10.25608/j877-kf56
Septième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2021/14.440/50. Brussels: Sciensano; 2021. doi: 10.25608/ht7a-8923
Huitième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2021/14.440/82. Brussels: Sciensano; 2021. doi: 10.25608/hqy9-m065
Neuvième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2022/14.440/3. Brussels: Sciensano; 2022. doi: 10.25608/evrs-je22
Dixième enquête de santé COVID-19 : résultats préliminaires. Deposit number D/2022/14.440/18. Brussels: Sciensano; 2022. doi: 10.25608/mve9-bk51
