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父母一方死亡的儿童和青年使用抗抑郁药的风险。

Risk of Use of Antidepressants Among Children and Young Adults Exposed to the Death of a Parent.

作者信息

Appel Charlotte Weiling, Johansen Christoffer, Christensen Jane, Frederiksen Kirsten, Hjalgrim Henrik, Dalton Susanne Oksbjerg, Dencker Annemarie, Dige Jes, Bøge Per, Dyregrov Atle, Mikkelsen Ole Abildgaard, Lund Lasse Wegener, Høybye Mette Terp, Bidstrup Pernille Envold

机构信息

From the aSurvivorship, Danish Cancer Society Research Center, Copenhagen, Denmark; bDiagnostic Center, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark; cOncology, Finsen Centre, Rigshospitalet 5073, Copenhagen, Denmark; dStatistics Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark; eDepartment of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; fDepartment of Patient Support & Community (PSC) Dealing with Bereavement, Danish Cancer Society, Copenhagen, Denmark; gCenter for Crisis Psychology, Bergen, Norway; hChildren's Welfare, Valby, Denmark; iJuliane Marie Centre, University Hospital Rigshospitalet, Pediatric Clinics, Copenhagen, Denmark; and jElective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark.

出版信息

Epidemiology. 2016 Jul;27(4):578-85. doi: 10.1097/EDE.0000000000000481.

Abstract

BACKGROUND

Insight into how early parental death impact psychological well-being in children and young adults is important to developing suitable supportive care. The purpose of this study was to investigate the association between early parental death before the child reaches age 30 years and subsequent use of antidepressants.

METHODS

Our nationwide population-based cohort of persons born in Denmark in 1970-1990 with follow-up in the period 1997-2009 comprised 1,124,215 persons, of whom 71,380 were bereaved. We used Poisson models to assess rate ratios for use of antidepressants according to early parental death.

RESULTS

Follow-up yielded 13,074,146 person-years at risk during which 93,347 persons used antidepressants. Persons who experienced early parental death had an increased risk for use of antidepressants (men: risk ratio, 1.21; 95% confidence interval, 1.16, 1.26; women: 1.23; 95% confidence interval, 1.19, 1.27). We observed stronger associations for women whose parent died by suicide than from other causes, who lost their mother rather than their father, and who lost a parent early rather than later. The increased risk remained more than 2 years from the loss.

CONCLUSIONS

Persons who lost a parent had an increased risk of use of antidepressants. Subgroups with particularly increased risk, included women, who were bereaved by suicides, who experienced loss of a mother, and who were bereaved when young. The risk of initiating antidepressant use was increased both immediately after the loss and later. Our results support that early parental death severely affects children`s psychological well-being.

摘要

背景

深入了解父母早亡对儿童和青年心理健康的影响对于制定合适的支持性护理至关重要。本研究的目的是调查儿童30岁之前父母早亡与随后使用抗抑郁药之间的关联。

方法

我们基于全国人口的队列研究对象为1970年至1990年出生在丹麦且在1997年至2009年期间接受随访的人群,共1,124,215人,其中71,380人经历了丧亲之痛。我们使用泊松模型根据父母早亡情况评估使用抗抑郁药的率比。

结果

随访产生了13,074,146人年的风险期,在此期间93,347人使用了抗抑郁药。经历父母早亡的人使用抗抑郁药的风险增加(男性:风险比为1.21;95%置信区间为1.16至1.26;女性:1.23;95%置信区间为1.19至1.27)。我们观察到,母亲自杀死亡而非因其他原因死亡、失去母亲而非父亲、早年而非晚年失去父母的女性之间的关联更强。这种增加的风险在丧亲后两年多仍存在。

结论

失去父母的人使用抗抑郁药的风险增加。风险特别增加的亚组包括女性、因自杀而丧亲者、失去母亲者以及早年丧亲者。丧亲后立即和之后使用抗抑郁药的风险均增加。我们的结果支持父母早亡会严重影响儿童的心理健康。

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