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诊断为儿童焦虑障碍的发病率和处方药物的使用:一项全国性登记研究。

Incidence of diagnosed pediatric anxiety disorders and use of prescription drugs: a nation-wide registry study.

机构信息

Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway.

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

Eur Child Adolesc Psychiatry. 2020 Aug;29(8):1063-1073. doi: 10.1007/s00787-019-01419-0. Epub 2019 Oct 22.

Abstract

The aim of this study was to calculate time trends in incidence of diagnosed anxiety disorders, including obsessive-compulsive disorder, and post-traumatic stress disorder, and to examine changes in use of prescribed drugs in the Norwegian pediatric population. Furthermore, we aimed to investigate whether comorbid mental disorders are associated with the use of prescribed drugs. Nation-wide registries with data from 2008 to 2015 were used, covering diagnostic data from primary health care [the Norwegian database for the control and reimbursement of health expenses (KUHR)] and secondary health care [the Norwegian Patient registry (NPR)], and data on prescribed drugs [the Norwegian prescription database, (NorPD)]. Data from the two latter were linked. During the period 2010-2015, 19,154 children and adolescents (61% girls) received a first diagnosis of anxiety disorders in primary care. The corresponding number from secondary care was 17,115 (61% girls). The incidence of diagnosed anxiety disorders increased over time, especially in girls, with an overall raise of ~ 2 per 1000 children across 2010-2015. Anti-anxiety drugs were used by < 12% of diagnosed children and < 25% of diagnosed adolescents, mainly by those with several contacts with the specialist health care system. There was no strong indications of an increase over time. Of other drugs, the most frequently prescribed were hypnotics and psychostimulants. Psychiatric comorbidity (33-55%) contributed to the use of drugs, including anti-anxiety drugs. The incidence of diagnosed anxiety disorders increased from 2010 to 2015, but the percentage using anti-anxiety drugs was stable. Drug use appears to be in line with the Norwegian guidelines.

摘要

本研究旨在计算诊断为焦虑障碍(包括强迫症和创伤后应激障碍)的发病率的时间趋势,并研究挪威儿科人群中处方药物使用的变化。此外,我们旨在研究共患精神障碍是否与处方药物的使用有关。使用了 2008 年至 2015 年的全国性登记处,这些登记处涵盖了初级保健的诊断数据(挪威控制和报销健康费用数据库(KUHR))和二级保健(挪威患者登记处(NPR)),以及处方药物的数据(挪威处方数据库(NorPD))。后两个数据库的数据是相互关联的。在 2010-2015 年期间,有 19154 名儿童和青少年(61%为女孩)在初级保健中首次被诊断出患有焦虑障碍。从二级保健中得到的相应数字是 17115 人(61%为女孩)。诊断为焦虑障碍的发病率随时间推移而增加,尤其是在女孩中,2010-2015 年间总体增加了约 2/1000 名儿童。接受诊断的儿童中,不到 12%使用了抗焦虑药物,不到 25%的接受诊断的青少年使用了抗焦虑药物,主要是那些与专科保健系统多次接触的人。没有迹象表明随时间推移而增加。其他药物中,最常开的是催眠药和精神兴奋剂。精神共病(33-55%)导致了药物的使用,包括抗焦虑药物。从 2010 年到 2015 年,诊断为焦虑障碍的发病率有所增加,但使用抗焦虑药物的比例保持稳定。药物的使用似乎符合挪威的指南。

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