Use of antidepressants among 0-26 year olds in Finland during 1997-2007

Abstract

-Background and Objectives:The use of antidepressants has increased in many Western countries among children, adolescents and young adults. The objective of this study was to analyse changes in incidence and prevalence of antidepressant use among patients aged 0 to 26 years from year 1997 to 2007.Methods: This is an observational population-based drug utilization study using a nationwide prescription register including data on reimbursed purchases of antidepressants for outpatient use.Results: The incidence and prevalence of antidepressant use increased about three fold during the study period. Among children less than 14 years of age both incidence and prevalence were low during the study period. In the age group 14-26 years, the incidence increased from 6.4 to 16.1 (per 1000 person-years) among men and from 9.7 to 28.3 among women, while the prevalence went up from 10.4 to 30.4 among men and from 15.5 to 56.8 among women. By the age of 26 years, 11.6% of men and 17.8% of women had purchased antidepressants at least once. The first antidepressant prescriptions were mainly prescribed by a specialist for children aged 7 to 15 years and by a non-specialist for the older age groups.

Treatment duration with selective serotonin reuptake inhibitors among children and adolescents in Finland: a nationwide register study

“…Younger children may have been monitored and followed up more closely, which has been shown to increase adherence [11]. More than 70% of psychopharmaceutical treatment for Finnish children aged <16 years is initiated by specialist physicians, whereas 59% is initiated by specialist physicians for adolescents aged 16-20 years [6]. In Finland, recipients of specialist secondary health care are routinely prompted to attend follow-up visits.…”

“…Antidepressant use among children and adolescents in Finland also starts to increase among children aged 12-15 years [6]. The final group was selected because it was assumed that adolescents aged ≥16 years were postpuberty, and use of antidepressants in Finland increases considerably among adolescents aged ≥16 years [6]. The season of initiation was categorized as summer (June-August), autumn (September-November), winter (December-February), or spring (March-May) based on the index date.…”

“…These categories were selected because the Finnish Current Care Guidelines for Depression recognize children aged ≥12 years as youths [15]. Antidepressant use among children and adolescents in Finland also starts to increase among children aged 12-15 years [6]. The final group was selected because it was assumed that adolescents aged ≥16 years were postpuberty, and use of antidepressants in Finland increases considerably among adolescents aged ≥16 years [6].…”

“…In Finland, 31% of children and adolescents aged <20 years who received a reimbursed SSRI from 1999 to 2005 received only one prescription [12]. Among people <26 years in Finland in 2007, 26% of males and 21% overall collected only one antidepressant prescription [6]. Treatment guidelines provide varying or minimal advice regarding optimum treatment duration with SSRIs among children and adolescents.…”

“…Selective serotonin reuptake inhibitors (SSRI) are the most widely used antidepressants among children and adolescents [6][7][8]. They are prescribed for indications of depressive disorders, anxiety, bulimia nervosa, obsessive compulsive disorder, panic disorder, posttraumatic stress disorder, and social phobias.…”