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Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study
Psychological Medicine, Volume: 46, Issue: 16, Pages: 3315 - 3327
Swansea University Authors:
Keith Lloyd , Michael Dennis, Joanna McGregor
, Ann John
, Amanda Marchant
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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DOI (Published version): 10.1017/s0033291716002099
Abstract
Concerns relating to increased use of psychotropic medication contrast with those of under-treatment and under-recognition of common mental disorders in children and young people (CYP) across developed countries. Little is known about the indications recorded for antidepressant prescribing in primar...
Published in: | Psychological Medicine |
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ISSN: | 0033-2917 1469-8978 |
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2016
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URI: | https://cronfa.swan.ac.uk/Record/cronfa34070 |
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<?xml version="1.0"?><rfc1807><datestamp>2020-06-22T16:26:59.9529854</datestamp><bib-version>v2</bib-version><id>34070</id><entry>2017-05-31</entry><title>Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study</title><swanseaauthors><author><sid>a13aaa0df9045c205e82ed3b95d18c10</sid><ORCID>0000-0002-1440-4124</ORCID><firstname>Keith</firstname><surname>Lloyd</surname><name>Keith Lloyd</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>e2fb156498bd28a936b34e986dfa01b7</sid><firstname>Michael</firstname><surname>Dennis</surname><name>Michael Dennis</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>caa651da7e3807cbeac8ec2f40643677</sid><ORCID>0000-0003-0242-4600</ORCID><firstname>Joanna</firstname><surname>McGregor</surname><name>Joanna McGregor</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>ed8a9c37bd7b7235b762d941ef18ee55</sid><ORCID>0000-0002-5657-6995</ORCID><firstname>Ann</firstname><surname>John</surname><name>Ann John</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>0776f450dd575004ba7c69930c579cae</sid><ORCID>0000-0001-7013-6980</ORCID><firstname>Amanda</firstname><surname>Marchant</surname><name>Amanda Marchant</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2017-05-31</date><deptcode>FGMHL</deptcode><abstract>Concerns relating to increased use of psychotropic medication contrast with those of under-treatment and under-recognition of common mental disorders in children and young people (CYP) across developed countries. Little is known about the indications recorded for antidepressant prescribing in primary care in CYP.This was an electronic cohort study of routinely collected primary-care data from a population of 1.9 million, Wales, UK. Poisson regression was undertaken to model adjusted counts of recorded depression symptoms, diagnoses and antidepressant prescriptions. Associated indications were explored.3 58 383 registered patients aged 6-18 years between 1 January 2003 and 31 December 2013 provided a total of 19 20 338 person-years of follow-up. The adjusted incidence of antidepressant prescribing increased significantly [incidence rate ratio (IRR) for 2013 = 1.28], mainly in older adolescents. The majority of new antidepressant prescriptions were for citalopram. Recorded depression diagnoses showed a steady decline (IRR = 0.72) while depression symptoms (IRR = 2.41) increased. Just over half of new antidepressant prescriptions were associated with depression (diagnosis or symptoms). Other antidepressant prescribing, largely unlicensed, was associated with diagnoses such as anxiety and pain.Antidepressant prescribing is increasing in CYP while recorded depression diagnoses decline. Unlicensed citalopram prescribing occurs outside current guidelines, despite its known toxicity in overdose. Unlicensed antidepressant prescribing is associated with a wide range of diagnoses, and while accepted practice, is often not supported by safety and efficacy studies. New strategies to implement current guidance for the management of depression in CYP are required.</abstract><type>Journal Article</type><journal>Psychological Medicine</journal><volume>46</volume><journalNumber>16</journalNumber><paginationStart>3315</paginationStart><paginationEnd>3327</paginationEnd><publisher/><issnPrint>0033-2917</issnPrint><issnElectronic>1469-8978</issnElectronic><keywords/><publishedDay>31</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2016</publishedYear><publishedDate>2016-12-31</publishedDate><doi>10.1017/s0033291716002099</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2020-06-22T16:26:59.9529854</lastEdited><Created>2017-05-31T15:39:36.2394468</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>A.</firstname><surname>John</surname><order>1</order></author><author><firstname>A. L.</firstname><surname>Marchant</surname><order>2</order></author><author><firstname>D. L.</firstname><surname>Fone</surname><order>3</order></author><author><firstname>J. I.</firstname><surname>McGregor</surname><order>4</order></author><author><firstname>M. S.</firstname><surname>Dennis</surname><order>5</order></author><author><firstname>J. O. A.</firstname><surname>Tan</surname><order>6</order></author><author><firstname>K.</firstname><surname>Lloyd</surname><order>7</order></author><author><firstname>Keith</firstname><surname>Lloyd</surname><orcid>0000-0002-1440-4124</orcid><order>8</order></author><author><firstname>Michael</firstname><surname>Dennis</surname><order>9</order></author><author><firstname>Joanna</firstname><surname>McGregor</surname><orcid>0000-0003-0242-4600</orcid><order>10</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>11</order></author><author><firstname>Amanda</firstname><surname>Marchant</surname><orcid>0000-0001-7013-6980</orcid><order>12</order></author></authors><documents><document><filename>0034070-13092017113015.pdf</filename><originalFilename>recent_trends_in_primarycare_antidepressant_prescribing_to_children_and_young_people_an_ecohort_study.pdf</originalFilename><uploaded>2017-09-13T11:30:15.6630000</uploaded><type>Output</type><contentLength>366324</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><embargoDate>2017-09-13T00:00:00.0000000</embargoDate><documentNotes>This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807> |
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2020-06-22T16:26:59.9529854 v2 34070 2017-05-31 Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study a13aaa0df9045c205e82ed3b95d18c10 0000-0002-1440-4124 Keith Lloyd Keith Lloyd true false e2fb156498bd28a936b34e986dfa01b7 Michael Dennis Michael Dennis true false caa651da7e3807cbeac8ec2f40643677 0000-0003-0242-4600 Joanna McGregor Joanna McGregor true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 0776f450dd575004ba7c69930c579cae 0000-0001-7013-6980 Amanda Marchant Amanda Marchant true false 2017-05-31 FGMHL Concerns relating to increased use of psychotropic medication contrast with those of under-treatment and under-recognition of common mental disorders in children and young people (CYP) across developed countries. Little is known about the indications recorded for antidepressant prescribing in primary care in CYP.This was an electronic cohort study of routinely collected primary-care data from a population of 1.9 million, Wales, UK. Poisson regression was undertaken to model adjusted counts of recorded depression symptoms, diagnoses and antidepressant prescriptions. Associated indications were explored.3 58 383 registered patients aged 6-18 years between 1 January 2003 and 31 December 2013 provided a total of 19 20 338 person-years of follow-up. The adjusted incidence of antidepressant prescribing increased significantly [incidence rate ratio (IRR) for 2013 = 1.28], mainly in older adolescents. The majority of new antidepressant prescriptions were for citalopram. Recorded depression diagnoses showed a steady decline (IRR = 0.72) while depression symptoms (IRR = 2.41) increased. Just over half of new antidepressant prescriptions were associated with depression (diagnosis or symptoms). Other antidepressant prescribing, largely unlicensed, was associated with diagnoses such as anxiety and pain.Antidepressant prescribing is increasing in CYP while recorded depression diagnoses decline. Unlicensed citalopram prescribing occurs outside current guidelines, despite its known toxicity in overdose. Unlicensed antidepressant prescribing is associated with a wide range of diagnoses, and while accepted practice, is often not supported by safety and efficacy studies. New strategies to implement current guidance for the management of depression in CYP are required. Journal Article Psychological Medicine 46 16 3315 3327 0033-2917 1469-8978 31 12 2016 2016-12-31 10.1017/s0033291716002099 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2020-06-22T16:26:59.9529854 2017-05-31T15:39:36.2394468 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine A. John 1 A. L. Marchant 2 D. L. Fone 3 J. I. McGregor 4 M. S. Dennis 5 J. O. A. Tan 6 K. Lloyd 7 Keith Lloyd 0000-0002-1440-4124 8 Michael Dennis 9 Joanna McGregor 0000-0003-0242-4600 10 Ann John 0000-0002-5657-6995 11 Amanda Marchant 0000-0001-7013-6980 12 0034070-13092017113015.pdf recent_trends_in_primarycare_antidepressant_prescribing_to_children_and_young_people_an_ecohort_study.pdf 2017-09-13T11:30:15.6630000 Output 366324 application/pdf Version of Record true 2017-09-13T00:00:00.0000000 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. true eng |
title |
Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study |
spellingShingle |
Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study Keith Lloyd Michael Dennis Joanna McGregor Ann John Amanda Marchant |
title_short |
Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study |
title_full |
Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study |
title_fullStr |
Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study |
title_full_unstemmed |
Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study |
title_sort |
Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study |
author_id_str_mv |
a13aaa0df9045c205e82ed3b95d18c10 e2fb156498bd28a936b34e986dfa01b7 caa651da7e3807cbeac8ec2f40643677 ed8a9c37bd7b7235b762d941ef18ee55 0776f450dd575004ba7c69930c579cae |
author_id_fullname_str_mv |
a13aaa0df9045c205e82ed3b95d18c10_***_Keith Lloyd e2fb156498bd28a936b34e986dfa01b7_***_Michael Dennis caa651da7e3807cbeac8ec2f40643677_***_Joanna McGregor ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John 0776f450dd575004ba7c69930c579cae_***_Amanda Marchant |
author |
Keith Lloyd Michael Dennis Joanna McGregor Ann John Amanda Marchant |
author2 |
A. John A. L. Marchant D. L. Fone J. I. McGregor M. S. Dennis J. O. A. Tan K. Lloyd Keith Lloyd Michael Dennis Joanna McGregor Ann John Amanda Marchant |
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Psychological Medicine |
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46 |
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3315 |
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Swansea University |
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0033-2917 1469-8978 |
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10.1017/s0033291716002099 |
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Faculty of Medicine, Health and Life Sciences |
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Faculty of Medicine, Health and Life Sciences |
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Faculty of Medicine, Health and Life Sciences |
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Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine |
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description |
Concerns relating to increased use of psychotropic medication contrast with those of under-treatment and under-recognition of common mental disorders in children and young people (CYP) across developed countries. Little is known about the indications recorded for antidepressant prescribing in primary care in CYP.This was an electronic cohort study of routinely collected primary-care data from a population of 1.9 million, Wales, UK. Poisson regression was undertaken to model adjusted counts of recorded depression symptoms, diagnoses and antidepressant prescriptions. Associated indications were explored.3 58 383 registered patients aged 6-18 years between 1 January 2003 and 31 December 2013 provided a total of 19 20 338 person-years of follow-up. The adjusted incidence of antidepressant prescribing increased significantly [incidence rate ratio (IRR) for 2013 = 1.28], mainly in older adolescents. The majority of new antidepressant prescriptions were for citalopram. Recorded depression diagnoses showed a steady decline (IRR = 0.72) while depression symptoms (IRR = 2.41) increased. Just over half of new antidepressant prescriptions were associated with depression (diagnosis or symptoms). Other antidepressant prescribing, largely unlicensed, was associated with diagnoses such as anxiety and pain.Antidepressant prescribing is increasing in CYP while recorded depression diagnoses decline. Unlicensed citalopram prescribing occurs outside current guidelines, despite its known toxicity in overdose. Unlicensed antidepressant prescribing is associated with a wide range of diagnoses, and while accepted practice, is often not supported by safety and efficacy studies. New strategies to implement current guidance for the management of depression in CYP are required. |
published_date |
2016-12-31T03:42:17Z |
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11.021648 |