Psychotropic drug use in adolescents born with an orofacial cleft: a population-based study

Nilsson, S; Merlo, Juan; Åhlander, Viveka Lyberg; Psouni, Elia

doi:10.1136/bmjopen-2014-005306

Cited by 16 publications

(15 citation statements)

References 71 publications

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“…7 Frequencies of alcohol consumption during pregnancy slightly lower than in the present study (22.5%) were reported by Campos Neves et al 6 (17.2%) and by Bezerra et al 37 (15%), both for the Brazilian population. A frequency of smoking higher than that observed in the present study (11.6%) was found by Nilsson et al 38 in a study of Swedish children with CL/P, in which 23% of the mothers reported cigarette smoking during pregnancy. A 45% frequency of pregnant women who smoked at any time during pregnancy was found by Little et al 39 in a study with 190 CL/P patients from Scotland and England.…”

Section: Discussioncontrasting

confidence: 81%

Risk factors and comorbidities in Brazilian patients with orofacial clefts

et al. 2018

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Considering that environmental risk factors substantially contribute to the etiology of orofacial clefts and that knowledge about the characteristics and comorbidities associated with oral clefts is fundamental to promoting better quality of life, this study aimed to describe the risk factors, main characteristics, and comorbidities of a group of patients with cleft lip and/or cleft palate (CL/P) from Rio Grande do Norte (RN), Brazil. Data were obtained from 173 patients with CL/P using a form from the Brazilian database on Orofacial Clefts. Most patients were male with cleft lip and palate and had a normal size and weight at birth; presented few neonatal intercurrent events; and had anemia and respiratory and cardiovascular diseases as main associated comorbidities. They also required timely surgical rehabilitation and multidisciplinary care to stimulate their neuropsychomotor development. In addition, a high frequency of familial recurrence and of parental consanguinity was evidenced in the studied population, especially for the cleft lip and cleft palate type. Other relevant findings were the considerable maternal exposure to alcohol, infections, smoking, and hypertension, as well as low supplementation with vitamins and minerals and deliberate consumption of analgesics, antibiotics, and antihypertensives during pregnancy. Characterization of the CL/P patient profile is essential for the planning of health services and integration among the health professionals involved in the diagnosis and treatment of these malformations. Our results reinforce the need for additional research to confirm the association between environmental factors and the development of orofacial clefts.

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Section: Discussioncontrasting

confidence: 81%

Risk factors and comorbidities in Brazilian patients with orofacial clefts

et al. 2018

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“…Our finding of increased use of psychotropic medications by individuals with CP is consistent with the recent study from Sweden focused on adolescents (Nilsson et al, ). That study also reported increased use among individuals with CL but not those with CLP.…”

Section: Discussionsupporting

confidence: 92%

“…Additional models were stratified by gender (because of variation in prevalence of mental health disorders and treatment use between male and female subjects), age group (0–34 and 34–76 years), and birth cohort (1936–1975 and 1976–2009). Furthermore, because a recent Swedish register‐based study on use of psychotropic medications in individuals with OC focused on adolescents (Nilsson et al, ) and many studies focus primarily on children (Hunt et al, ; Murray et al, ; Wehby et al, ; Tyler et al, ), we also restricted analyses to the children and adolescent (aged 0–17 years). Additionally for the outcomes with significant findings, additional analyses were stratified by severity, including separating unilateral and bilateral status for CLP; submucous, soft palate only, or soft and hard palate for CP; and cleft laterality (left‐sided vs. right‐sided) for unilateral CLP.…”

Section: Methodsmentioning

confidence: 99%

“…One weakness of work focusing on diagnoses at psychiatric hospitals is overrepresentation of severe psychiatric disorders requiring hospitalizations and underrepresentation of less severe mental health problems like milder anxiety disorders and mild to moderate depression, which are disorders that would generally be treated in the primary healthcare system. A recent study that investigated psychotropic drug use in adolescence using Swedish national registers and captured nonhospitalized cases found increased medication use for adolescents with CL and those with CP but not for individuals with CLP (Nilsson et al, ). That study, however, only included adolescents, and did not investigate specific types of psychotropic medications to further understand medication use patterns and underlying illnesses.…”

Section: Introductionmentioning

confidence: 99%

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Use of Psychotropic Medications and Visits to Psychiatrists and Psychologists among Individuals with Nonsyndromic Oral Clefts: A Population‐Based Cohort Study

Pedersen

Hageman

Wehby

et al. 2017

Birth Defects Research

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Background Oral clefts (OC) are among the most common congenital malformations and can have a large impact on the life of the affected individual. Research findings regarding the psychological and psychosocial consequences of OC are inconclusive. Methods Using Danish nationwide registers we investigated redeemed prescriptions of psychotropic medication 1996–2012 and visits to psychiatrists and psychologists 1996–2011 among individuals born with non-syndromic OC in Denmark 1936–2009 and a comparison cohort of individuals without OC. This includes 8,244 individuals with OC and 82,665 individuals without OC. Results Cox-regression analysis revealed 12% (95%CI: 7%–16%) increased risk of using any psychotropic medication for individuals with OC. When examining by cleft type, higher risks for medication use were observed in individuals with cleft lip and palate (CLP) or cleft palate only (CP). The largest increased relative risk was found for use of antipsychotics and stimulants for individuals with CP followed by use of antipsychotics for individuals with CLP. We found increased risk of visits to psychiatrists for individuals with CP and no increased risk for visits to psychologists for either group. Conclusions This study indicates that a small group of individuals with non-syndromic OC, in particular those with palatal involvement, have greater risk of using psychotropic medications. Elevated use was however also observed among younger individuals with cleft lip only. There seems to be only a modest increase in visits to health professionals for psychological reasons. Undiagnosed syndromes, e.g. 22q11 deletion syndrome, may however contribute to an overestimation of the associations.

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“…18 Recently, a large Swedish population-based study showed that CL and CPO increase the risk for psychotropic drug use in adolescence; however, there was no distinction made among the different groups of psychotropic drugs or psychiatric indications. 19 The majority of previous studies are small, underpowered, and clinically based, and focus on psychological symptoms rather than psychiatric disorders as a medical diagnosis.…”

mentioning

confidence: 99%

Increased Risk for Neurodevelopmental Disorders in Children With Orofacial Clefts

Tillman

Hakelius

Höijer

et al. 2018

Journal of the American Academy of Child & Adolescent Psych

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Objective: Children with orofacial clefts (OFC) may have an increased risk of poor mental health. This study aimed to investigate the risk of psychiatric diagnoses in individuals with OFC, stratified by cleft type. Method: A nationwide register-based cohort of all individuals born with nonsyndromic OFC in Sweden between 1973 and 2012 (n ¼ 7,842) was compared to a matched cohort (n ¼ 78,409) as well as to their unaffected siblings (n ¼ 9,637). The risk of psychiatric diagnoses, suicide attempts, and suicides was examined by crude and adjusted Cox regression models. Effect modification by sex was investigated with interaction terms in the models. Results: Children with cleft lip (CL) had a significantly higher risk of any psychiatric disorder, intellectual disability, and language disorders; children with cleft lip and palate (CLP) had, in addition, an increased risk of autism spectrum disorder (ASD). Children with cleft palate only (CPO) had risk increases for the same diagnoses as children with CL and CLP, but with higher hazard ratios, and also for psychotic disorders, attention-deficit/ hyperactivity disorder (ADHD), and other behavioral or emotional disorders in childhood. Sex stratification indicated higher risk increases among females in CL and CLP but not in CPO. Siblings without OFC were less likely to be diagnosed with any psychiatric disorder, intellectual disability, language disorder, ASD, or ADHD compared to their siblings with OFC. Conclusion: Children with nonsyndromic clefts had a significantly higher risk of neurodevelopmental disorders. This risk is unlikely to be explained by familial influences such as inherited genetic or shared environmental factors.

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Psychotropic drug use in adolescents born with an orofacial cleft: a population-based study

Cited by 16 publications

References 71 publications

Risk factors and comorbidities in Brazilian patients with orofacial clefts

Risk factors and comorbidities in Brazilian patients with orofacial clefts

Use of Psychotropic Medications and Visits to Psychiatrists and Psychologists among Individuals with Nonsyndromic Oral Clefts: A Population‐Based Cohort Study

Increased Risk for Neurodevelopmental Disorders in Children With Orofacial Clefts

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