Incidence and prevalence of primary care antidepressant prescribing in children and young people in England, 1998–2017: A population-based cohort study

Jack, Ruth H; Hollis, Chris; Coupland, Carol; Morriss, Richard; Knaggs, Roger; Butler, Debbie; Cipriani, Andrea; Cortese, Samuele; Hippisley‐Cox, Julia

doi:10.1371/journal.pmed.1003215

Cited by 37 publications

(32 citation statements)

References 25 publications

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“…We found that the prevalence of psychotropic drug use varied between genders and classes of psychotropic medications. Similar results regarding a general increase, and gender and psychotropic drug class patterns have also been reported among children and adolescents ( 12 – 16 ). In particular, an increased use of hypnotics and antidepressants in adolescents has received attention ( 12 , 13 , 16 ).…”

Section: Discussionsupporting

confidence: 84%

“…Similar results regarding a general increase, and gender and psychotropic drug class patterns have also been reported among children and adolescents ( 12 – 16 ). In particular, an increased use of hypnotics and antidepressants in adolescents has received attention ( 12 , 13 , 16 ). Of note, the increased hypnotics usage can largely be attributed to the increased use of melatonin ( 12 , 13 , 15 ), which until 2020 was a prescription drug in Norway.…”

Section: Discussionsupporting

confidence: 84%

“…RR and RD are reported with 95 per cent confidence intervals (95% CI). Stata v. 16 was used for all data management and statistical analysis (40).…”

Section: Discussionmentioning

confidence: 99%

“…A psychotropic drug can be defined as any drug affecting the mind, emotions and behaviour, e.g., stimulants, antidepressants, antipsychotics, anxiolytics, and hypnotics. Parallel to the striking increase in psychological distress in adolescents and young adults ( 10 , 11 ), the use of psychotropic drugs among children and adolescents has increased in many countries in the last decade ( 12 – 16 ). The same trends have been observed in young adults.…”

Section: Introductionmentioning

confidence: 99%

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Psychological Distress and Use of Psychotropic Drugs Among University Students—the SHoT Study, Norway

et al. 2021

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Background: Students pursuing higher education are struggling with psychological distress, which in turn may negatively affect their academic self-efficacy and study progress. Although psychotropic drug use is widespread and increasing, patterns of psychotropic drug use among students are not well-known.Aim: To describe prevalence and gender differences in psychotropic drug use among Norwegian students in higher education, and to examine associations with level of psychological distress.Methods: The study is based on data from the Norwegian Student's Health and Well-being Study (SHoT), 2018, a national survey including all fulltime students aged 18–35 years in higher education. Our sample included 49,836 students, 69% females. Use of psychotropic drugs and psychological distress (The Hopkins Symptoms Checklist [HSCL-25]) were self-reported. Generalised linear models were used to assess associations between psychological distress and psychotropic drug use.Results: Psychotropic drug use was more frequent among female than male students: 4 vs. 2% daily antidepressants usage; 5 vs. 3% last month use of anxiolytics/tranquillisers; and 8 vs. 5% last month use of hypnotics. In contrast, male students reported use of performance enhancing drugs more often than females (7 vs. 5%). Adjusted associations between high level of psychological distress (HSCL-25 ≥ 2.0) and use of psychotropics, showed an about 2-fold increased relative risk, largely consequent across drug classes and genders.Conclusion: Prevalence and gender patterns of intake of the most common psychotropic drug classes among Norwegian students are comparable to previous studies. Unexpectedly, among students with moderate to severe psychological distress, the patterns of psychotropic drug use were more or less identical between genders.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 84%

“…RR and RD are reported with 95 per cent confidence intervals (95% CI). Stata v. 16 was used for all data management and statistical analysis (40).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychological Distress and Use of Psychotropic Drugs Among University Students—the SHoT Study, Norway

et al. 2021

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“…23 25 The number of 12-to 17-year-olds prescribed antidepressants more than doubled between 2005 and 2017. 26…”

Section: Questions Relating To Efficacymentioning

confidence: 99%

Newer generation antidepressants and withdrawal effects: reconsidering the role of antidepressants and helping patients to stop

Horowitz

Wilcock

2021

DTB

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In England, the prescribing of antidepressants, primarily the newer generation antidepressant classes, has steadily increased over recent years. There is ongoing debate about how the efficacy of these drugs is viewed, their place in therapy and the harms associated with stopping them. Much of the evidence of their efficacy comes from short-term placebo-controlled trials which tend not to include outcomes that are of greatest relevance to patients, such as social functioning or quality of life, but rather restrict outcomes narrowly to symptom measures. On such measures these studies do not demonstrate clinically significant differences from placebo for depression. A range of adverse effects are also recognised, often greater in naturalistic studies of long-term antidepressants users than those measured in short-term efficacy studies, including emotional numbing, sexual difficulties, fatigue and weight gain. There is increasing recognition that withdrawal symptoms from antidepressants are common and that these symptoms can be severe and long-lasting in some patients. Recent guidance on how to stop antidepressants in a tolerable way has been presented by the Royal College of Psychiatrists. We believe that increasing awareness about the difficulty that some patients have in stopping antidepressants should lead to more cautious prescribing practice, with antidepressants given to fewer patients and for shorter periods of time. This article discusses the perceived benefits and harms of antidepressant use.

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Association Between Race and COVID-19 Outcomes Among 2.6 Million Children in England

et al. 2021

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IMPORTANCE Although children mainly experience mild COVID-19 disease, hospitalization rates are increasing, with limited understanding of underlying factors. There is an established association between race and severe COVID-19 outcomes in adults in England; however, whether a similar association exists in children is unclear.OBJECTIVE To investigate the association between race and childhood COVID-19 testing and hospital outcomes. DESIGN, SETTING, PARTICIPANTSIn this cohort study, children (0-18 years of age) from participating family practices in England were identified in the QResearch database between January 24 and November 30, 2020. The QResearch database has individually linked patients with national SARS-CoV-2 testing, hospital admission, and mortality data.EXPOSURES The main characteristic of interest is self-reported race. Other exposures were age, sex, deprivation level, geographic region, household size, and comorbidities (asthma; diabetes; and cardiac, neurologic, and hematologic conditions). MAIN OUTCOMES AND MEASURESThe primary outcome was hospital admission with confirmed COVID-19. Secondary outcomes were SARS-CoV-2-positive test result and any hospital attendance with confirmed COVID-19 and intensive care admission. RESULTS Of 2 576 353 children (mean [SD] age, 9.23 [5.24] years; 48.8% female), 410 726 (15.9%) were tested for SARS-CoV-2 and 26 322 (6.4%) tested positive. A total of 1853 children (0.07%) with confirmed COVID-19 attended hospital, 343 (0.01%) were admitted to the hospital, and 73 (0.002%) required intensive care. Testing varied across race. White children had the highest proportion of SARS-CoV-2 tests (223 701/1 311 041 [17.1%]), whereas Asian children (33 213/243 545 [13.6%]), Black children (7727/93 620 [8.3%]), and children of mixed or other races (18 971/147 529 [12.9%]) had lower proportions. Compared with White children, Asian children were more likely to have COVID-19 hospital admissions (adjusted odds ratio [OR], 1.62; 95% CI, 1.12-2.36), whereas Black children (adjusted OR, 1.44; 95% CI, 0.90-2.31) and children of mixed or other races (adjusted OR, 1.40; 95% CI, 0.93-2.10) had comparable hospital admissions. Asian children were more likely to be admitted to intensive care (adjusted OR, 2.11; 95% CI, 1.07-4.14), and Black children (adjusted OR, 2.31; 95% CI, 1.08-4.94) and children of mixed or other races (adjusted OR, 2.14; 95% CI, 1.25-3.65) had longer hospital admissions (Ն36 hours). CONCLUSIONS AND RELEVANCEIn this large population-based study exploring the association between race and childhood COVID-19 testing and hospital outcomes, several race-specific disparities were observed in severe COVID-19 outcomes. However, ascertainment bias and residual confounding in this cohort study should be considered before drawing any further conclusions. Overall, findings of this study have important public health implications internationally.

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Incidence and prevalence of primary care antidepressant prescribing in children and young people in England, 1998–2017: A population-based cohort study

Cited by 37 publications

References 25 publications

Psychological Distress and Use of Psychotropic Drugs Among University Students—the SHoT Study, Norway

Psychological Distress and Use of Psychotropic Drugs Among University Students—the SHoT Study, Norway

Newer generation antidepressants and withdrawal effects: reconsidering the role of antidepressants and helping patients to stop

Association Between Race and COVID-19 Outcomes Among 2.6 Million Children in England

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