Norwegian Institute of Public Health, Oslo.
Norwegian Centre for Addiction Research, University of Oslo, Oslo.
Acta Psychiatr Scand. 2018 May;137(5):413-421. doi: 10.1111/acps.12877. Epub 2018 Apr 5.
To study if the observed increase in use of antidepressants (AD) among adolescents may be explained by higher incidence of depressive disorder diagnosis, increasing treatment of other mental disorders or more liberal prescribing practice.
We used three different study populations of girls and boys aged 13-17 years in Norway: 1) individuals who were diagnosed with depressive disorders in primary health care, 2) individuals who were diagnosed with depressive disorders in secondary health care; 3) individuals who were dispensed ADs as recorded in the prescription database. Dataset 2) and 3) were linked.
Incidence of depressive disorders increased from 2010 to 2015 both in primary and secondary health care, especially in girls. One in four girls with incident depressive disorders was prescribed ADs and this proportion was stable over time. Among girls treated with ADs the proportion with a diagnosis where AD treatment is indicated increased from 61.1% to 66.0%. Furthermore, the proportion with moderate or severe episodes of major depressive disorders was stable and high, 72.9% in 2014.
The only issue studied that could explain increasing AD use in girls was increasing incidence of depressive disorders. Most adolescents with incident diagnosis of depressive disorders were not treated with ADs.
研究青少年抗抑郁药（AD）使用增加是否可以用抑郁障碍诊断发病率增加、其他精神障碍治疗增加或更宽松的处方实践来解释。
我们使用了挪威三个不同的 13-17 岁女孩和男孩的研究人群：1）在初级保健中被诊断为抑郁障碍的个体；2）在二级保健中被诊断为抑郁障碍的个体；3）在处方数据库中被开具 AD 的个体。数据集 2）和 3）被关联。
初级保健和二级保健中抑郁障碍的发病率均从 2010 年到 2015 年增加，尤其是女孩。四分之一患有新发抑郁障碍的女孩被开具 AD 处方，且这一比例随时间稳定。在接受 AD 治疗的女孩中，AD 治疗指征的诊断比例从 61.1%增加到 66.0%。此外，中重度重性抑郁障碍发作的比例稳定且较高，2014 年为 72.9%。
唯一可以解释女孩中 AD 使用增加的因素是抑郁障碍的发病率增加。大多数新发抑郁障碍诊断的青少年并未接受 AD 治疗。
