{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T07:17:00Z","timestamp":1788160620459,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Human Psychopharmacology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Anxiolytic medications, particularly benzodiazepines, are widely prescribed, giving impetus to long\u2010standing debates about how often these agents should be employed in clinical practice. There are, however, few cross\u2010country 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.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Face\u2010to\u2010face interviews with community samples totaling\n n<\/jats:italic>\n \u00a0=\u00a049,919 respondents in the World Health Organization World Mental Health (WMH) Surveys asked about anxiolytic medication use anytime in the prior 12\u00a0months in conjunction with validated fully structured diagnostic interviews. Treatment questions were administered independently of diagnoses to all respondents.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A weighted 5.6% (\n n<\/jats:italic>\n \u00a0=\u00a04079) of respondents reported anxiolytic medication use within the past 12\u00a0months; the vast majority comprised benzodiazepine use, and use was highest amongst respondents with a subthreshold major depressive episode (MDE) (25.2%) and a 12\u2010month MDE (19.8%). Rates were significantly higher in high\u2010income countries (HICs) than low\u2010 and middle\u2010income countries (LMICs) (8.5% vs. 2.2%, \u03c7\n 2<\/jats:sup>\n 1<\/jats:sub>\n \u00a0=\u00a0559.6,\n p<\/jats:italic>\n \u00a0<\u00a00.001). Short\u2010acting benzodiazepines and z\u2010drugs were most commonly used for sleep (66.5% and 85.5%), while intermediate\u2010acting benzodiazepines and long\u2010acting benzodiazepines were most commonly used either for sleep (37.9% and 30.1%) or anxiety (33.3% and 32.0%). Across all conditions, anxiolytic medications were reported as\n very<\/jats:italic>\n effective by 55.7% of users and\n somewhat<\/jats:italic>\n effective by an additional 32.2% of users, with similar proportions in HICs and LMICs. Negative predictors of high perceived effectiveness were a 12\u2010month MDE and taking anxiolytic medication for comorbid anxiety and depression.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n These 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/hup.70031","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:06:09Z","timestamp":1767189969000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anxiolytic Medication Use in Low\u2010 Middle\u2010 and High\u2010Income Countries: A World Mental Health Surveys Report"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7218-7810","authenticated-orcid":false,"given":"Dan J.","family":"Stein","sequence":"first","affiliation":[{"name":"Department of Psychiatry & Neuroscience Institute SAMRC Unit on Risk & Resilience in Mental Disorders University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan E.","family":"Kazdin","sequence":"additional","affiliation":[{"name":"Department of Psychology Yale University New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3343-0907","authenticated-orcid":false,"given":"David S.","family":"Baldwin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith G.","family":"Harris","sequence":"additional","affiliation":[{"name":"School of Public Health The University of Queensland Herston Australia"},{"name":"Queensland Centre for Mental Health Research The Park Centre for Mental Health Wacol Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irving","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia R.","family":"Pozuelo","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy Harvard Medical School Boston Massachusetts USA"},{"name":"Department of Psychiatry University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A.","family":"Sampson","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Woodruff","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health University of Sheffield Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Carmen","family":"Viana","sequence":"additional","affiliation":[{"name":"Department of Social Medicine Postgraduate Program in Public Health Federal University of Esp\u00edrito Santo Vit\u00f3ria Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Aguilar\u2010Gaxiola","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Center for Reducing Health Disparities UC Davis Health System Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Al\u2010Hamzawi","sequence":"additional","affiliation":[{"name":"College of Medicine Al\u2010Qadisiya University Diwaniya Governorate Diwaniya Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Alonso","sequence":"additional","affiliation":[{"name":"Health Services Research Unit IMIM\u2010Hospital del Mar Medical Research Institute Barcelona Spain"},{"name":"Pompeu Fabra University (UPF) Barcelona Spain"},{"name":"CIBER en Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP) Barcelona 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