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Table 1 Patient demographics and clinical characteristics

From: Patterns of hypnotic prescribing for residual insomnia and recurrence of major depressive disorder: a retrospective cohort study using a Japanese health insurance claims database

Variable Alla (N = 2946) Monotherapy Combination therapy
Benzodiazepine (n = 1067) Non-benzodiazepine (n = 850) Melatonin receptor agonist (n = 76) Orexin receptor antagonist (n = 94) Total (n = 2087) 2 drugs (n = 622) 3 drugs (n = 166) ≥4 drugs (n = 71) Total (n = 859)
Age, years, mean ± SD 41.6 ± 10.2 42.4 ± 9.9 42.2 ± 10.0 38.3 ± 11.2 42.5 ± 11.4 42.2 ± 10.1 40.5 ± 10.4 38.9 ± 10.1 38.9 ± 9.1 40.1 ± 10.2
 < 40 years, n (%) 1214 (41.2) 404 (37.9) 328 (38.6) 37 (48.7) 40 (42.6) 809 (38.8) 284 (45.7) 84 (50.6) 37 (52.1) 405 (47.1)
 ≥ 40 years, n (%) 1732 (58.8) 663 (62.1) 522 (61.4) 39 (51.3) 54 (57.4) 1278 (61.2) 338 (54.3) 82 (49.4) 34 (47.9) 454 (52.9)
Sex, n (%)
 Male 1850 (62.8) 693 (64.9) 507 (59.6) 44 (57.9) 51 (54.3) 1295 (62.1) 403 (64.8) 105 (63.3) 47 (66.2) 555 (64.6)
Insured or dependent, n (%)
 Insured 2186 (74.2) 805 (75.4) 619 (72.8) 49 (64.5) 68 (72.3) 1541 (73.8) 468 (75.2) 124 (74.7) 53 (74.6) 645 (75.1)
 Spouse 567 (19.2) 201 (18.8) 187 (22.0) 14 (18.4) 25 (26.6) 427 (20.5) 103 (16.6) 24 (14.5) 13 (18.3) 140 (16.3)
 Other family member 193 (6.6) 61 (5.7) 44 (5.2) 13 (17.1) 1 (1.1) 119 (5.7) 51 (8.2) 18 (10.8) 5 (7.0) 74 (8.6)
History of psychiatric disordersb, n (%)
 Anxiety disorder 489 (16.6) 179 (16.8) 155 (18.2) 14 (18.4) 16 (17.0) 364 (17.4) 89 (14.3) 23 (13.9) 13 (18.3) 125 (14.6)
 Bipolar disorder 14 (0.5) 3 (0.3) 8 (0.9) 1 (1.3) 0 12 (0.6) 2 (0.3) 0 (0) 0 2 (0.2)
 Schizophrenia 40 (1.4) 18 (1.7) 5 (0.6) 1 (1.3) 0 24 (1.1) 10 (1.6) 6 (3.6) 0 16 (1.9)
 ADHD 2 (0.1) 0 0 0 0 0 2 (0.3) 0 0 2 (0.2)
 Autism 1 (0.0) 0 0 0 0 0 1 (0.2) 0 0 1 (0.1)
Comorbid psychiatric disordersc, n (%)
 Anxiety disorder 1200 (40.7) 416 (39.0) 343 (40.4) 36 (47.7) 45 (47.9) 840 (40.2) 263 (42.3) 62 (37.3) 35 (49.3) 360 (41.9)
 Bipolar disorder 509 (17.3) 167 (15.7) 78 (9.2) 10 (13.2) 13 (13.8) 268 (12.8) 166 (26.7) 47 (28.3) 28 (39.4) 241 (28.1)
 Schizophrenia 466 (15.8) 179 (16.8) 61 (7.2) 6 (7.9) 13 (13.8) 259 (12.4) 138 (22.2) 47 (28.3) 22 (31.0) 207 (24.1)
 ADHD 48 (1.6) 16 (1.5) 4 (0.5) 2 (2.6) 3 (3.2) 25 (1.2) 13 (2.1) 9 (5.4) 1 (1.4) 23 (2.7)
 Autism 2 (0.1) 0 0 0 0 0 2 (0.3) 0 0 2 (0.2)
History of medication at baselineb, n (%)
 Steroid, hormonal drug 1437 (48.8) 501 (47.0) 452 (53.2) 36 (47.4) 53 (56.4) 1042 (49.9) 293 (47.1) 73 (44.0) 29 (40.8) 395 (46.0)
 Anxiolytics 555 (18.8) 201 (18.8) 176 (20.7) 15 (19.7) 18 (19.1) 410 (19.6) 101 (16.2) 31 (18.7) 13 (18.3) 145 (16.9)
 Leukotriene receptor antagonists 276 (9.4) 96 (9.0) 82 (9.6) 6 (7.9) 9 (9.6) 193 (9.2) 54 (8.7) 21 (12.7) 8 (11.3) 83 (9.7)
 Neurological medication, psychotropic drug 198 (6.7) 66 (6.2) 60 (7.1) 2 (2.6) 5 (5.3) 133 (6.4) 43 (6.9) 15 (9.0) 7 (9.9) 65 (7.6)
 Analgesic, anti-inflammatory 187 (6.3) 67 (6.3) 55 (6.5) 1 (1.3) 8 (8.5) 131 (6.3) 44 (7.1) 11 (6.6) 1 (1.4) 56 (6.5)
 Antibacterial and/or antifungal 179 (6.1) 56 (5.2) 53 (6.2) 5 (6.6) 4 (4.3) 118 (5.7) 41 (6.6) 15 (9.0) 5 (7.0) 61 (7.1)
 Antihypertensive, cardiotonic 52 (1.8) 14 (1.3) 22 (2.6) 3 (3.9) 1 (1.1) 40 (1.9) 8 (1.3) 4 (2.4) 0 12 (1.4)
 Antipsychotic 49 (1.7) 18 (1.7) 13 (1.5) 1 (1.3) 0 32 (1.5) 10 (1.6) 7 (4.2) 0 17 (2.0)
 Antismoking product 21 (0.7) 9 (0.8) 5 (0.6) 0 0 14 (0.7) 7 (1.1) 0 0 7 (0.8)
 Antineoplastic 7 (0.2) 2 (0.2) 3 (0.4) 1 (1.3) 1 (1.1) 7 (0.3) 0 0 0 0
 Mood stabilizer 2 (0.1) 1 (0.1) 1 (0.1) 0 0 2 (0.1) 0 0 0 0
 Immunostimulant 2 (0.1) 2 (0.2) 0 0 0 2 (0.1) 0 0 0 0
 Centrally-acting anti-obesity product 1 (0) 0 0 0 0 0 1 (0.2) 0 0 1 (0.1)
 Other 324 (11.0) 124 (11.6) 92 (10.8) 9 (11.8) 14 (14.9) 239 (11.5) 56 (9.0) 19 (11.4) 10 (14.1) 85 (9.9)
Concomitant medication at baselinec, n (%)
 Steroid, hormonal drug 1118 (37.9) 383 (35.9) 353 (41.5) 27 (35.5) 40 (42.6) 803 (38.5) 229 (36.8) 55 (33.1) 31 (43.7) 315 (36.7)
 Anxiolytics 1427 (48.4) 521 (48.8) 361 (42.5) 39 (51.3) 47 (50.0) 968 (46.4) 319 (51.3) 96 (57.8) 44 (62.0) 459 (53.4)
 Leukotriene receptor antagonists 173 (5.9) 60 (5.6) 58 (6.8) 5 (6.6) 6 (6.4) 129 (6.2) 27 (4.3) 12 (7.2) 5 (7.0) 44 (5.1)
 Neurological medication, psychotropic drug 260 (8.8) 92 (8.6) 54 (6.4) 7 (9.2) 6 (6.4) 159 (7.6) 60 (9.6) 24 (14.5) 17 (23.9) 101 (11.8)
 Analgesic, anti-inflammatory 96 (3.3) 36 (3.4) 26 (3.1) 2 (2.6) 1 (1.1) 65 (3.1) 22 (3.5) 9 (5.4) 0 31 (3.6)
 Antibacterial and/or antifungal 115 (3.9) 34 (3.2) 33 (3.9) 2 (2.6) 6 (6.4) 75 (3.6) 27 (4.3) 9 (5.4) 4 (5.6) 40 (4.7)
 Antihypertensive, cardiotonic 82 (2.8) 26 (2.4) 26 (3.1) 2 (2.6) 2 (2.1) 56 (2.7) 17 (2.7) 7 (4.2) 2 (2.8) 26 (3.0)
 Antipsychotic 607 (20.6) 222 (20.8) 89 (10.5) 10 (13.2) 16 (17.0) 337 (16.1) 178 (28.6) 59 (35.5) 33 (46.5) 270 (31.4)
 Antismoking product 17 (0.6) 3 (0.6) 4 (0.5) 0 1 (1.1) 8 (0.4) 4 (0.6) 4 (2.4) 1 (1.4) 9 (1.0)
 Antineoplastic 12 (0.4) 4 (0.4) 4 (0.5) 1 (1.3) 1 (1.1) 10 (0.5) 1 (0.2) 0 1 (1.4) 2 (0.2)
 Mood stabilizer 215 (7.3) 63 (5.9) 27 (3.2) 5 (6.6) 4 (4.3) 99 (4.7) 73 (11.7) 26 (15.7) 17 (23.9) 116 (13.5)
 Immunostimulant 1 (0) 1 (0.1) 0 0 0 1 (0.0) 0 0 0 0
 Centrally-acting anti-obesity product 2 (0.1) 0 0 0 0 0 1 (0.2) 1 (0.6) 0 2 (0.2)
 Other 231 (7.8) 80 (7.5) 68 (8.0) 4 (5.3) 7 (7.4) 159 (7.6) 48 (7.7) 19 (11.4) 5 (7.0) 72 (8.4)
Sedative antidepressant, n (%) 917 (31.1) 288 (27.0) 251 (29.5) 26 (34.2) 38 (40.4) 603 (28.9) 221 (35.5) 65 (39.2) 28 (39.4) 314 (36.6)
 Mirtazapine 600 (20.4) 177 (16.6) 165 (19.4) 20 (26.3) 26 (27.7) 388 (18.6) 149 (24.0) 43 (25.9) 20 (28.2) 212 (24.7)
 Trazodone hydrochloride 360 (12.2) 122 (11.4) 87 (10.2) 10 (13.2) 12 (12.8) 231 (11.1) 88 (14.1) 27 (16.3) 14 (19.7) 129 (15.0)
 Mianserin hydrochloride 95 (3.2) 31 (2.9) 19 (2.2) 1 (1.3) 4 (4.3) 55 (2.6) 28 (4.5) 8 (4.8) 4 (5.6) 40 (4.7)
Antidepressant dosage at end of treatment, n (%)
 < Recommended maximum dose 2740 (93.0) 987 (92.5) 806 (94.8) 70 (92.1) 91 (96.8) 1954 (93.6) 570 (91.6) 150 (90.4) 66 (93.0) 786 (91.5)
 ≥ Recommended maximum dose 206 (7.0) 80 (7.5) 44 (5.2) 6 (7.9) 3 (3.2) 133 (6.4) 52 (8.4) 16 (9.6) 5 (7.0) 73 (8.5)
Dosage of antidepressants during treatment (mg/day)d, n (%)
 Mean (95% CI) 74.3 (72.3–76.3) 73.0 (69.9–76.1) 68.2 (64.8–71.7) 67.3 (52.9–81.7) 69.1 (57.9–80.4) 70.7 (68.4–72.9) 82.5 (77.4–87.7) 87.7 (77.7–97.7) 77.4 (66.6–88.3) 83.1 (78.8–87.4)
 Median (IQR) 64.9 (37.5, 100.0) 65.5 (37.5, 100.0) 58.4 (37.5, 81.2) 46.4 (37.5, 75.0) 60.2 (30.0. 85.7) 61.1 (37.5, 93.5) 71.0 (37.5, 105.1) 75.0 (37.5, 120.1) 75.0 (38.1, 105.0) 73.0 (37.5, 106.8)
 < 75 mg/day 1678 (57.0) 605 (56.7) 526 (61.9) 53 (69.7) 54 (57.4) 1238 (59.3) 328 (52.7) 80 (48.2) 32 (45.1) 440 (51.2)
 ≥ 75 and < 150 mg/day 1005 (34.1) 378 (35.4) 264 (31.1) 16 (21.1) 32 (34.0) 690 (33.1) 218 (35.0) 62 (37.3) 35 (49.3) 315 (36.7)
 ≥ 150 mg/day 263 (8.9) 84 (7.9) 60 (7.1) 7 (9.2) 8 (8.5) 159 (7.6) 76 (12.2) 24 (14.5) 4 (5.6) 104 (12.1)
  1. aAnalysis set for 1-year recurrence rate; bWithin 12 months prior to treatment for depression; cWithin 6 months before start of the follow-up period; dConverted to values that are equivalent to imipramine using a dose-equivalence scale for antidepressants [20].
  2. ADHD Attention deficit hyperactivity disorder, CI Confidence interval, IQR Interquartile range, SD Standard deviation