Psychotropic medication use in parents of survivors of adolescent cancer: A register‐based cohort study

Abstract

Background The aim was to investigate psychotropic medication use in parents of survivors of adolescent cancer from the acute post‐diagnostic phase and up to 2 years following the cancer diagnosis. Methods This study had a nationwide register‐based cohort design comparing psychotropic medication use in parents of adolescent survivors of cancer ( n = 2323) to use in parents of cancer‐free controls ( n = 20,868). Cox proportional hazards models, adjusted for cancer diagnostic group, parents' age, country of birth, education level, marital status and previous mental health problems estimated the risk of use from the time of the cancer diagnosis up to 2 years later. Results During the first 6 months after the cancer diagnosis, both mothers and fathers had an increased risk of use of anxiolytics (mothers: HR adj 1.71, 95% CI 1.30–2.25; fathers: HR adj 1.57, 95% CI 1.10–2.45) and hypnotics/sedatives (mothers: HR adj 1.53, 95% CI 1.23–1.90; fathers: HR adj 1.32, 95% CI 1.00–1.75). For fathers with a prescription of psychotropic medication during the first 6 months after the cancer diagnosis, the risk remained increased after 6 months (HR adj 1.66, 95% CI 1.04–2.65). From 6 months after the cancer diagnosis, only the risk of antidepressant use among mothers was increased (HR adj 1.38, 95% CI 1.08–1.76). Risk factors included being divorced/widowed, born in a non‐Nordic country, older age and having had previous mental health problems. Conclusion Our study results show that during the immediate post‐diagnostic phase, mothers and fathers of survivors of adolescent cancer are at increased risk of use of anxiolytics and sedatives, whereas only mothers are at increased risk of antidepressant use from 6 months until 2 years after the diagnosis. Further, previous mental health problems were shown to be the strongest risk factor for psychotropic medication use in both mothers and fathers, pointing to the particular vulnerability of these parents.

Losing a child to adolescent cancer: A register‐based cohort study of psychotropic medication use in bereaved parents

“…In the context of childhood cancer, the outcome is often uncertain and many parents recognize the possibility of their child's death at the time of diagnosis. We have previously shown that parents of survivors of adolescent cancer (excluding bereaved parents) are at increased risk of use of anxiolytics and sedatives in the immediate post‐diagnostic phase 24 . The results of the present study might thus reflect parents' reactions to the initial cancer diagnosis as well.…”

“…We have previously shown that parents of survivors of adolescent cancer (excluding bereaved parents) are at increased risk of use of anxiolytics and sedatives in the immediate post‐diagnostic phase. 24 The results of the present study might thus reflect parents' reactions to the initial cancer diagnosis as well. Aligned with this, anticipatory grief responses have been reported by parents of children newly diagnosed with cancer.…”

“…This study is part of a larger research project on psychiatric consequences of adolescent cancer 23,24 . A diagnosis of cancer in adolescence occurs at a phase of physical, cognitive, psychological, and social development.…”

“…This study is part of a larger research project on psychiatric consequences of adolescent cancer. 23 , 24 A diagnosis of cancer in adolescence occurs at a phase of physical, cognitive, psychological, and social development. In addition to existing adolescent developmental challenges, adolescents with cancer and their parents are faced with specific cancer‐related stressors, including restrictions in activity, isolation from healthy peers, increased dependency on parents, and changes in physical appearance.…”

Parenting a child with cancer and maintaining a healthy couple relationship: Findings from the Family Talk Intervention

“…Previous research shows that a high proportion of parents of children with cancer report distress, such as anxiety, post‐traumatic stress symptoms, worry, and nervousness 2,3 . The burden of care often places a strain on the well‐being of parents, and, accordingly, an increased risk of psychotropic medication use has been reported, especially among mothers 4,5 . In addition, having a child with cancer may negatively impact levels of income and employment status, which can put further strain on the family 6 .…”