Gender differences in adolescent anxiolytic, hypnotic and sedative use across 32 European countries: a multilevel analysis of the influence of country-level gender inequality and economic factors.

Despite consistent evidence of higher anxiolytic, hypnotic, and sedative (AHS) use among adolescent girls, influence of country-level context in shaping gendered patterns remains unexplored. This study examines how national gender inequality and economic factors affect adolescent AHS use and its gen...

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Publicado en:European Journal of Public Health Vol. 36; no. 2; pp. 1 - 8
Autores principales: Martinez-Mendia, Xabi, Bacigalupe, Amaia, Moreno-Llamas, Antonio
Formato: equations & formulas research tables/charts Journal Article
Publicado: Oxford University Press / USA Apr2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2026
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      pub: Oxford University Press / USA
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        atl: Gender differences in adolescent anxiolytic, hypnotic and sedative use across 32 European countries: a multilevel analysis of the influence of country-level gender inequality and economic factors.
      aug:
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          Martinez-Mendia, Xabi
          Bacigalupe, Amaia
          Moreno-Llamas, Antonio
        affil: Research Group in Social Determinants of Health and Demographic Change-OPIK, University of the Basque Country (UPV/EHU), Leioa, Biscay, SpainDepartment of Sociology and Social Work, Faculty of Social and Communication Sciences, University of the Basque Country (UPV/EHU), Leioa, Biscay, SpainDoctoral Programme in Public Health, Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Biscay, Spain
      sug:
        subj:
          Mental Disorders Drug Therapy
          Antianxiety Agents Therapeutic Use
          Hypnotics and Sedatives Therapeutic Use
          Sex Factors Evaluation
          Gender Equality Evaluation
          Socioeconomic Factors Evaluation
          Drug Utilization Evaluation
          Europe
          Human
          Funding Source
          Female
          Male
          Adolescence
          Cross Sectional Studies
          Descriptive Statistics
          Comparative Studies
          Multiple Logistic Regression
          Multivariate Analysis
          Health Services Accessibility
          Geographic Factors
          Odds Ratio
          Income
          Sensitivity and Specificity
          Data Analysis Software
          Adolescent Behavior
          Adolescent: 13-18 years
          Female
          Male
      ab: Despite consistent evidence of higher anxiolytic, hypnotic, and sedative (AHS) use among adolescent girls, influence of country-level context in shaping gendered patterns remains unexplored. This study examines how national gender inequality and economic factors affect adolescent AHS use and its gender differences in Europe. We analysed cross-sectional data from 96 954 adolescents aged 15–16 across 32 European countries using the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD). Countries were grouped into tertiles according to the Gender Inequality Index (GII), GDP per capita and Gini index. We calculated lifetime AHS use prevalence and gender prevalence ratios (PRs). Multilevel logistic regressions estimated the contribution of country-level context to consumption variability, and the association of national inequalities and wealth with boys' and girls' consumption, adjusting for individual sociodemographic variables and AHS accessibility. Most countries showed significantly higher AHS use among girls. Countries with higher gender and income inequality and lower GDP per capita reported overall lower consumption and wider gender gaps (e.g. PRGII-Low = 1.18 [1.12–1.25], PRGII-High = 1.49 [1.40–1.59]). Country-level context accounted for 6.7% of between-country consumption variance. Significant interactions between country level context and gender were found, such that gender gaps were wider in countries with greater gender inequality (ORGII-Med*Girls = 1.16 [1.05–1.28], ORGII-High*Girls = 1.33 [1.19–1.48]), lower GDP per capita (ORGDP-Low*Girls = 1.25 [1.12–1.38]), and higher income inequality (ORGini-High*Girls = 1.19 [1.07–1.32]). Structural inequalities in gender and wealth were associated with adolescent AHS use across Europe. Focusing on cultural factors, medicalisation processes and their gendered impact could provide a meaningful framework for mental health interventions.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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