Movatterモバイル変換

[0]ホーム
URL:

Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
Thehttps:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

NIH NLM Logo
Log inShow account info
Access keysNCBI HomepageMyNCBI HomepageMain ContentMain Navigation
pubmed logo
Advanced Clipboard
User Guide

Full text links

Public Library of Science full text link Public Library of Science Free PMC article
Full text links

Actions

Share

doi: 10.1371/journal.pone.0033181. Epub 2012 Mar 13.

Trends in depression and antidepressant prescribing in children and adolescents: a cohort study in The Health Improvement Network (THIN)

Affiliations

Trends in depression and antidepressant prescribing in children and adolescents: a cohort study in The Health Improvement Network (THIN)

Linda P M M Wijlaars et al. PLoS One.2012.

Abstract

Background: In 2003, the Committee on Safety of Medicines (CSM) advised against treatment with selective serotonin reuptake inhibitors (SSRIs) other than fluoxetine in children, due to a possible increased risk of suicidal behaviour. This study examined the effects of this safety warning on general practitioners' depression diagnosing and prescription behaviour in children.

Methods and findings: We identified a cohort of 1,502,753 children (<18 y; registered with GP for >6 m) in The Health Improvement Network (THIN) UK primary care database. Trends in incidence of depression diagnoses, symptoms and antidepressant prescribing were examined 1995-2009, accounting for deprivation, age and gender. We used segmented regression analysis to assess changes in prescription rates. Overall, 45,723 (3%) children had ≥ 1 depression-related entry in their clinical records. SSRIs were prescribed to 16,925 (1%) of children. SSRI prescription rates decreased from 3.2 (95%CI:3.0,3.3) per 1,000 person-years at risk (PYAR) in 2002 to 1.7 (95%CI:1.7,1.8) per 1,000 PYAR in 2005, but have since risen to 2.7 (95%CI:2.6,2.8) per 1,000 PYAR in 2009. Prescription rates for CSM-contraindicated SSRIs citalopram, sertraline and especially paroxetine dropped dramatically after 2002, while rates for fluoxetine and amitriptyline remained stable. After 2005 rates for all antidepressants, except paroxetine and imipramine, started to rise again. Rates for depression diagnoses dropped from 3.0 (95%CI:2.8,3.1) per 1,000 PYAR in 2002 to 2.0 (95%CI:1.9,2.1) per 1,000 PYAR in 2005 and have been stable since. Recording of symptoms saw a steady increase from 1.0 (95%CI:0.8,1.2) per 1,000 PYAR in 1995 to 4.7 (95%CI:4.5,4.8) per 1,000 PYAR in 2009.

Conclusions: The rates of depression diagnoses and SSRI prescriptions showed a significant drop around the time of the CSM advice, which was not present in the recording of symptoms. This could indicate caution on the part of GPs in making depression diagnoses and prescribing antidepressants following the CSM advice.

PubMed Disclaimer

Conflict of interest statement

Competing Interests:The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Venn diagram which shows the intersection between depression diagnoses, symptoms and antidepressant prescriptions.
Figure 2
Figure 2. Trends in the incidence of childhood depression, symptoms and antidepressants from 1995 to 2009.
Figure 3
Figure 3. Rates of prescription of Tricyclic Antidepressants (TCA) and Selective Serotonin Reuptake Inhibitors (SSRI) in children.
Figure 4
Figure 4. Observed and modelled prescription rates for individual (A) Selective Serotonin Reuptake Inhibitors (SSRIs) and (B) Tricyclic Antidepressants (TCAs).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Murray ML, de Vries CS, Wong IC. A drug utilisation study of antidepressants in children and adolescents using the General Practice Research Database. Arch Dis Child. 2004;89:1098–1102. - PMC - PubMed
    1. Stark P, Hardison CD. A review of multicenter controlled studies of fluoxetine vs. imipramine and placebo in outpatients with major depressive disorder. J Clin Psychiatry. 1985;46:53–58. - PubMed
    1. Hazell P, O'Connell D, Heathcote D, Henry DA. Tricyclic drug for depression in children and adolescents. Cochrane Database Syst Rev. 2002 10.1002/14651858.CD002317. - PubMed
    1. Keller MB, Ryan ND, Strober M, Klein RG, Kutcher SP, et al. Efficacy of paroxetine in the treatment of adolescent major depression: a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry. 2001;40:762–772. - PubMed
    1. Emslie GJ, Heiligenstein JH, Wagner KD, Hoog SL, Ernest DE, et al. Fluoxetine for acute treatment of depression in children and adolescents: a placebo-controlled, randomized clinical trial. J Am Acad Child Adolesc Psychiatry. 2002;41:1205–1215. - PubMed

Publication types

MeSH terms

Substances

Related information

Grants and funding

LinkOut - more resources

Full text links
Public Library of Science full text link Public Library of Science Free PMC article
Cite
Send To

NCBI Literature Resources

MeSHPMCBookshelfDisclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

[8]ページ先頭
©2009-2025 Movatter.jp