Discussion
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We found a significant, albeit weak association between exposure to downsizing and prevalence of anxiolytic and sedative drugs. The results indicated that the use of these psychotropic drugs increased most for stayers during and after downsizing.The different time trends in purchases of psychotropic drugs between exposed and unexposed employees, during certain phases, indicated that downsizing might entail treatment of mental health problems. During the period prior to the downsizing event, often referred to as the anticipation phase, it was primarily the unemployed and the changer groups that seemed to experience an increase in psychotropic drug purchases. The findings are in accordance with previous studies showing that the anticipation phase before a job change or unemployment has predominantly detrimental health effects [While the prevalence of purchasing psychotropic drugs decreased among the unemployed it increased among those who stayed within the organization after a downsizing. This could be a result of an increased work load [According to a previous study which followed employees in Sweden from two years before to two years after an organizational downsizing, employees exposed to downsizing had higher odds of purchasing prescribed antidepressant compared to employees unexposed to downsizing [In order to address the possibility that the results were explained by health selection we stratified our sample by previous sickness absence. Bernstrom [