Evidence map›Paper›PMID 41474294›Full record

ArticleHuman psychopharmacology2026

Anxiolytic Medication Use in Low- Middle- and High-Income Countries: A World Mental Health Surveys Report.

Dan J Stein, Alan E Kazdin, David S Baldwin, Meredith G Harris, Irving Hwang, Julia R Pozuelo, Nancy A Sampson, Peter Woodruff, Maria Carmen Viana, Sergio Aguilar-Gaxiola and 22 more

Abstract read
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In one paragraph

Article in Human psychopharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Dan J SteinDepartment of Psychiatry & Neuroscience Institute, SAMRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa.ORCID 0000-0001-7218-7810
Alan E KazdinDepartment of Psychology, Yale University, New Haven, Connecticut, USA.
David S BaldwinFaculty of Medicine, University of Southampton, Southampton, UK.ORCID 0000-0003-3343-0907
Meredith G HarrisSchool of Public Health, The University of Queensland, Herston, Australia.
Irving HwangDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
Julia R PozueloDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
Nancy A SampsonDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
Peter WoodruffSchool of Medicine and Population Health, University of Sheffield, Sheffield, UK.
Maria Carmen VianaDepartment of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil.
Sergio Aguilar-GaxiolaDepartment of Internal Medicine, Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA.
Ali Al-HamzawiCollege of Medicine, Al-Qadisiya University, Diwaniya Governorate, Diwaniya, Iraq.
Jordi AlonsoHealth Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.
Laura Helena AndradeNúcleo de Epidemiologia Psiquiátrica - LIM 23, Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Corina BenjetDepartment of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.ORCID 0000-0002-4569-6094
Ronny BruffaertsUniversitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium.
José-Miguel Caldas-de-AlmeidaLisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
Stephanie ChardoulSurvey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
Giovanni de GirolamoIRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.ORCID 0000-0002-1611-8324
Oye GurejeDepartment of Psychiatry, University College Hospital, Ibadan, Nigeria.
Josep M HaroParc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain.
Elie G KaramDepartment of Psychiatry and Clinical Psychology, Faculty of Medicine, St George University of Beirut, Beirut, Lebanon.ORCID 0000-0002-4681-8225
Aimee KaramDepartment of Psychiatry and Clinical Psychology, Faculty of Medicine, St George University of Beirut, Beirut, Lebanon.
Viviane Kovess-MasfetyEcole des Hautes Etudes en Santé Publique (EHESP), Paris Descartes University, Paris, France.
Fernando Navarro-MateuUnidad de Docencia, Investigación y Formación en Salud Mental, Gerencia Salud Mental, Servicio Murciano de Salud, Murcia, Spain.
Daisuke NishiDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
José Posada-VillaColegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia.
Annelieke RoestDepartment of Developmental Psychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands.
Juan Carlos StagnaroDepartamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
Cristian VladescuNational Institute for Health Services Management, Bucharest, Romania.
Daniel V VigoDepartment of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Ronald C KesslerDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0003-4831-2305
WHO World Mental Health Survey collaborators

Funding

EPIDEMIOLOGY-- NATIONAL COMORBIDITY SURVEY REPLICATIONU01MH060220 · NIMH · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI KESSLER, RONALD C · 1999 to 2010
$18.7M
Risk Factors for Psychopathology in the WHO WMH SurveysR01MH070884 · NIMH · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI KESSLER, RONALD C · 2005 to 2009
$6.0M
Social Role Disability and Mental-Physical Co-MorbidityR01MH069864 · NIMH · KAISER FOUNDATION HEALTH PLAN OF WASHINGTON · PI VON KORFF, MICHAEL R · 2004 to 2007
$2.2M
CROSS-NATIONAL STUDIES OF DRUG INVOLVEMENT: WMH2000R01DA016558 · NIDA · MICHIGAN STATE UNIVERSITY · PI ANTHONY, JAMES CHRISTOPHER · 2003 to 2008
$1.7M
World Mental Health Consortium Annual Meeting 2003-07R13MH066849 · NIMH · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HEERINGA, STEVEN G · 2003 to 2007
$735k
World Mental Health Consortium Annual Meetings 2008-2012U13MH066849 · NIMH · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HEERINGA, STEVEN G · 2008 to 2012
$647k
Lebanon-Epidemiology: The NCS Replication StudyR03TW006481 · FIC · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI KESSLER, RONALD C · 2004 to 2006
$142k
FIC NIH HHS R03 TW006481NIDA NIH HHS R01 DA016558NIMH NIH HHS R01 MH069864NIMH NIH HHS R01 MH070884NIMH NIH HHS R13 MH066849NIMH NIH HHS U01 MH060220NIMH NIH HHS U13 MH066849
6 · The paper itself

Abstract

backgroundAnxiolytic medications, particularly benzodiazepines, are widely prescribed, giving impetus to long-standing debates about how often these agents should be employed in clinical practice. There are, however, few cross-country studies of the pharmacoepidemiology of these agents. We report on the frequency of anxiolytic medication use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries.

methodsFace-to-face interviews with community samples totaling n = 49,919 respondents in the World Health Organization World Mental Health (WMH) Surveys asked about anxiolytic medication use anytime in the prior 12 months in conjunction with validated fully structured diagnostic interviews. Treatment questions were administered independently of diagnoses to all respondents.

resultsA weighted 5.6% (n = 4079) of respondents reported anxiolytic medication use within the past 12 months; the vast majority comprised benzodiazepine use, and use was highest amongst respondents with a subthreshold major depressive episode (MDE) (25.2%) and a 12-month MDE (19.8%). Rates were significantly higher in high-income countries (HICs) than low- and middle-income countries (LMICs) (8.5% vs. 2.2%, χ

conclusionThese data do not definitely answer the question of how often benzodiazepines should be prescribed in clinical practice, but they usefully inform discussions of how to optimize their use. It is noteworthy that anxiolytic medications, particularly benzodiazepines, are largely prescribed for anxiety and sleep, and that they are widely perceived to be either very or somewhat effective by users. However, more targeted prescription of these agents may be necessary; in particular antidepressant intervention should be prioritized in the pharmacotherapy of major depressive disorder.

Indexed as

Anti-Anxiety AgentsAnxiety DisordersBenzodiazepinesDeveloping CountriesAdolescentAdultAgedDeveloped CountriesFemaleGlobal HealthHealth SurveysHumansMajor Depressive DisorderMaleMiddle AgedYoung AdultAnti-Anxiety AgentsBenzodiazepinesanxiolytic medicationsperceived effectivenessreasons for use

Identifiers

PMID41474294
PMCPMC12755120

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.