Antidepressant Use Among Children and Adolescents Across the Scandinavian Countries

Saturday, August 27, 2022

1:00 PM – 1:15 PM CEST

Location: C1M0

Publication Number: 169

Background: We have previously shown considerable differences in prevalent use of antidepressants among youths from Sweden, Norway, and Denmark.

Objectives: To extend the examination of patterns of antidepressant (AD) use among children and adolescents in Scandinavia.

Methods: Using individual-level dispensing data from Sweden, Norway, and Denmark, we identified new users of ADs aged 5-17 years during 2007-2018. We examined incidence of AD use, duration of AD treatment, concurrent psychotropic drug use, and specialty of prescribing physician. Analyses were stratified by age and sex. Duration of treatment was calculated as the proportion of patients covered by an AD prescription after 12 months disregarding treatment breaks and assuming the use of one tablet per day while adding a grace period of 25%.

Results: From 2007-2018, the incidence of AD use increased in Sweden (from 3.0 to 6.0/1,000 persons) and Norway (2.0 to 2.5/1,000) and decreased in Denmark (2.8 to 1.8/1,000). In 2018, 14-17-year-old girls had the highest incidence, especially in Sweden (20/1,000), compared to Norway (10/1,000) and Denmark (6.0/1,000). After 12 months, more children were in current AD treatment (disregarding treatment breaks) in Sweden (57%) compared to Norway (40%) and Denmark (48%). However, when we only considered the first episode of AD use, the proportion still in treatment after 12 months was 33% in Sweden, 25% in Norway and 30% in Denmark. Swedish youths were more likely to have a concurrent use of other psychotropics (57%) compared to Norwegian (37%) and Danish (27%) youths. Concurrent drug use was more common for boys than girls in Denmark and Norway, whereas there was no sex difference in Swedish youths >9 years. ADs were mainly prescribed by specialists, however with variation over time. From 2013-2017, general practitioners were more likely to initiate antidepressant treatment in Norway (29%) and Denmark (25%) compared to Sweden (15%).

Conclusions: The incidence of AD use varied across Scandinavia and was highest in Swedish adolescent girls. Swedish AD users were characterized by more concurrent psychotropic drug use and used antidepressants for a longer time when disregarding treatment breaks compared to Danish and Norwegian peers. Future studies should examine how predictors of AD use differ between countries.

Presenting Author(s)

LR

Lotte Rasmussen

University of Southern Denmark
Odense C, Syddanmark, Denmark

Slides

Co-Author(s)

PJ

Peter Jensen

Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Denmark, Denmark
JR

Johan Reutfors

M.D., Ph.D., associate professor
Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden, Sweden
LB

Lena Brandt

B.Sc., statistician
Centre for Pharmacoepidemiology, Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden, Sweden
KF

Kari Furu

Department of Chronic Diseases, Norwegian Institute of Public Health, Norway, Norway
SS

Svetlana Skurtveit

Department of Mental Disorders, Norwegian Institute of Public Health, Norway, Oslo, Norway
RS

Randi Selmer

Department of Chronic Diseases, Norwegian Institute of Public Health, Norway, Norway
PD

Per Damkier, MD, PhD

Professor, consultant
Department of Clinical Pharmacology, Odense University Hospital, Denmark and Department of Clinical Research, University of Southern Denmark, Denmark, Denmark
Mette Bliddal, PhD

Associate professor
University of Southern Denmark (Department of Clinical Research)
University of Southern Denmark
Odense C, Syddanmark, Denmark
Rikke Wesselhoeft

Associate Professor MD PhD
University of Southern Denmark
University of Southern Denmark
Odense C, Syddanmark, Denmark