Increase in diagnosis of depressive disorders contributes to the increase in antidepressant use in adolescents

Bramness, Jørgen G.; Hjellvik, Vidar; Hartz, Ingeborg; Nesvåg, Ragnar; Hauge, Lars Johan; Handal, Marte

doi:10.1111/acps.12877

Cited by 21 publications

(12 citation statements)

References 27 publications

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“…The temporal increases in incidence rates that we report for depression are, in terms of their magnitude, consistent with those reported from previous studies conducted in the UK [22] and in Norway [24]. In both sexes, incidence was higher at ages 13-16 and 17-19, but younger age groups saw larger relative increases.…”

Section: Discussionsupporting

confidence: 91%

Temporal trends in annual incidence rates for psychiatric disorders and self-harm among children and adolescents in the UK, 2003–2018

et al. 2021

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Background There has been growing concern in the UK over recent years that a perceived mental health crisis is affecting children and adolescents, although published epidemiological evidence is limited. Methods Two population-based UK primary care cohorts were delineated in the Aurum and GOLD datasets of the Clinical Practice Research Datalink (CPRD). We included data from 9,133,246 individuals aged 1–20 who contributed 117,682,651 person-years of observation time. Sex- and age-stratified annual incidence rates were estimated for attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) (age groups: 1–5, 6–9, 10–12, 13–16, 17–19), depression, anxiety disorders (6–9, 10–12, 13–16, 17–19), eating disorders and self-harm (10–12, 13–16, 17–19) during 2003–2018. We fitted negative binomial regressions to estimate incidence rate ratios (IRRs) to examine change in incidence between the first (2003) and final year (2018) year of observation and to examine sex-specific incidence. Results The results indicated that the overall incidence has increased substantially in both boys and girls in between 2003 and 2018 for anxiety disorders (IRR 3.51 95% CI 3.18–3.89), depression (2.37; 2.03–2.77), ASD (2.36; 1.72–3.26), ADHD (2.3; 1.73–3.25), and self-harm (2.25; 1.82–2.79). The incidence for eating disorders also increased (IRR 1.3 95% CI 1.06–1.61), but less sharply. The incidence of anxiety disorders, depression, self-harm and eating disorders was in absolute terms higher in girls, whereas the opposite was true for the incidence of ADHD and ASD, which were higher among boys. The largest relative increases in incidence were observed for neurodevelopmental disorders, particularly among girls diagnosed with ADHD or ASD. However, in absolute terms, the incidence was much higher for depression and anxiety disorders. Conclusion The number of young people seeking help for psychological distress appears to have increased in recent years. Changes to diagnostic criteria, reduced stigma, and increased awareness may partly explain our results, but we cannot rule out true increases in incidence occurring in the population. Whatever the explanation, the marked rise in demand for healthcare services means that it may be more challenging for affected young people to promptly access the care and support that they need.

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Section: Discussionsupporting

confidence: 91%

Temporal trends in annual incidence rates for psychiatric disorders and self-harm among children and adolescents in the UK, 2003–2018

et al. 2021

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“…This is in line with previous studies conducted in EDs (4, 12). This is also consistent with an increase in self-reported symptoms of depression during adolescence reported in general populations (22), and longitudinal data collected in both primary and secondary health care services (23). Interestingly, in our study such increase was not associated with a corresponding rise in the number of diagnosed depressive disorders.…”

Section: Discussionsupporting

confidence: 86%

Changes in the Use of Emergency Care for the Youth With Mental Health Problems Over Decades: A Repeated Cross Sectional Study

et al. 2019

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To understand whether changes exist in the types of youths mental health problems addressed in emergency in a context of increasing demand, we conducted a retrospective chart review in an emergency care outpatient unit. Data from children and adolescents admitted at four different time periods (years 1981, 1992, 2002, and 2017) were compared to determine trends in terms of patients' characteristics, nature of the mental health problems and final care decisions. Between 1981 and 2017 there was a 3.85 times increase in the annual number of patients presenting to the emergency consultations. The proportion of youths being referred for anxiety or depressive symptoms sharply increased over time, while no differences were found for the proportion of aggressive behaviors and suicidal attempts. Anxiety disorders became the most frequent discharge psychiatric disorder in youths admitted in the emergency unit, rising from 5% in 1981 to 34% in 2017. Significant changes were also observed in the source of referral to the emergency unit; in particular emergency consultations in 2017 were about twice as likely as in 1981 to be requested directly by the family. This data suggested that the increased use of emergency services observed over the last decades is associated with significant changes in the patient and his/her family's demands about mental health difficulties. Such findings are worth considering for mental health interventions that aim to address the emergency overcrowding issue.

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“…Finally, centrally acting sympathomimetics (ATC N06BA) are primarily used to treat ADHD. Not that there is no one-to-one relationship between a specific prescription drug and a diagnosis or problem (Skurtveit et al 2018;Wong et al 2016). For example, while selective serotonin reuptake inhibitors (SSRIs) are classified within the ATC classification system as antidepressants, they are also the preferred drug for treating pediatric anxiety disorders (Ask et al 2019;Wesselhoeft et al 2020).…”

Section: Life Course Outcomesmentioning

confidence: 99%

Every tenth child: Heterogeneity in characteristics and life-course patterns among children in contact with child welfare services

Borgen¹,

Frønes²,

Raaum³

2022

Preprint

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Every tenth Norwegian child has been in contact with the child welfare services (CWS) before age 18. This paper describes the variation in background characteristics of CWS children with different types of services and their life-course trajectories from ages 10 to 25, compared to other children. We use high-quality population-wide Norwegian register data, covering about 860 000 children from birth cohorts 1987-2001, of which roughly 85 000 have received a CWS initiative. CWS children typically have lower socioeconomic backgrounds than other children. In terms of individual outcomes, they are more likely to have a criminal charge, be prescribed drugs for mental health and ADHD, fail in the educational system, and experience labor market marginalization. However, the heterogeneity among CWS children receiving different initiatives is more pronounced than differences between those in contact and those not. Adolescents with multisystemic therapy (MST) have the most unfavorable life-course patterns, in line with children in childcare institutions. Still, MST youth enter CWS late and have an advantaged family background compared to other CWS children, suggesting that individual-level risk factors are particularly important for sorting into MST.

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Increase in diagnosis of depressive disorders contributes to the increase in antidepressant use in adolescents

Abstract: The only issue studied that could explain increasing AD use in girls was increasing incidence of depressive disorders. Most adolescents with incident diagnosis of depressive disorders were not treated with ADs.

Cited by 21 publications

References 27 publications

Temporal trends in annual incidence rates for psychiatric disorders and self-harm among children and adolescents in the UK, 2003–2018

Temporal trends in annual incidence rates for psychiatric disorders and self-harm among children and adolescents in the UK, 2003–2018

Changes in the Use of Emergency Care for the Youth With Mental Health Problems Over Decades: A Repeated Cross Sectional Study

Every tenth child: Heterogeneity in characteristics and life-course patterns among children in contact with child welfare services

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