Impacto da interação medicamentosa de psicofármacos e de transtornos mentais comuns autorreferidos na qualidade de vida de estudantes de pós-graduação stricto sensu no contexto da pandemia de covid-19

Abstract

Among the university population, an increase in the prevalence of common mental disorders can be observed due to several factors, including the transition to the university environment as a critical and challenging period, distancing from family and friends, thus developing new social connections and increasing autonomy and responsibility. As a result, there is an increase in the use of psychotropic medications, and consequent drug interactions that can compromise the quality of life among Brazilian stricto sensu graduate students during the COVID-19 pandemic. This study aimed to evaluate the impact of drug interactions and the use of psychotropic drugs, as well as the presence of self-reported common mental disorders on the quality of life of Brazilian stricto sensu graduate students in the context of the COVID-19 pandemic. This is a cross-sectional analytical study carried out with stricto sensu graduate students enrolled in Brazilian programs who self-reported using more than one psychotropic drug, totaling a sample of 595 students. Data were collected through an electronic form via email and/or WhatsApp, through the REDCap (Research Electronic Data Capture) platform containing sociodemographic, economic, health history, academic aspects, as well as information on the use of psychotropic drugs, self-report of common mental disorders. And for the perception of quality of life, the WHOQOLbref of the World Health Organization was used. Descriptive and inferential statistical analyses and regression testing were used to investigate the relationships between the variables and understand the effects of drug interactions. This study was approved by the Research Ethics Committee (CEP) of the Ribeirão Preto School of Nursing under opinion 5,384,965. Of the 595 participants, the majority were female, selfdeclared white, with a predominance of singles and lived in the Southeast region of Brazil. Regarding the academic profile, the majority were in the area of Health Sciences and were unemployed. The most self-reported CMDs were depression and anxiety disorder. They used antidepressants, anxiolytics, sedatives and psychomotor stimulants. Regarding the interactions between psychotropic medications, most presented interactions, and of these were considered serious. When assessing quality of life, the environmental domain had the highest average and the psychological domain the lowest. When analyzing the influence of sociodemographic predictors in the WHOQol-bref domains, it can be noted that the only predictor variable that impacted all four quality of life domains was the presence of depression, which presented lower average quality of life scores in the four dimensions. Having panic syndrome affected the psychological, physical and environmental domains; bipolar affective disorder negatively influenced the psychological domain; and personality disorder negatively affected the physical domain. Regarding the use of psychotropic drugs, the use of sedatives had the greatest negative impact, reducing the average quality of life, but only in the physical domain (beta = -0.13, p = 0.002), followed by the use of antipsychotics in the environmental (beta = -0.11, p = 0.014) and physical (beta = -0.09, p = 0.041) domains, and the use of stimulants, which negatively impacted only the psychological domain (beta = -0.09, p = 0.031). The academic profile variables included in the model did not influence quality of life. Regarding the sociodemographic profile, having a partner influenced the environmental domain, and increased income resulted in a decrease in the quality of life score in the psychological domain. It is worth noting that the potential drug interaction did not present a statistically significant relationship with any quality of life domain, a fact also verified in the preliminary bivariate analyses. Universities need to create and implement effective mental health support policies that encourage comprehensive and unified treatment, addressing the multiple interactions between mental health, pharmacological treatment, and quality of life. Implementing these measures is essential to ensure the well-being and academic success of stricto sensu graduate students, especially during challenging times such as the COVID-19 pandemic