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失去青少年癌症患儿:基于登记的丧亲父母使用精神药物的队列研究。

Losing a child to adolescent cancer: A register-based cohort study of psychotropic medication use in bereaved parents.

机构信息

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

出版信息

Cancer Med. 2023 Mar;12(5):6148-6160. doi: 10.1002/cam4.5347. Epub 2022 Oct 11.

Abstract

PURPOSE

To investigate the short- and long-term risk of psychotropic medication use in parents who lose a child to cancer diagnosed in adolescence.

METHODS

This is a Swedish nationwide register-based study including 184 bereaved mothers and 184 bereaved fathers of 184 children diagnosed with cancer in adolescence. Logistic regression analyses, adjusted for sociodemographic characteristics and history of mental health problems, were performed to estimate risk of a prescription of psychotropic medication (anxiolytics, hypnotics/sedatives, antidepressants) in cancer-bereaved parents from 1 year before to 5 years after the child's death, with a general population sample of non-bereaved parents (n = 3291) as referents.

RESULTS

At the year of the child's death, 28%-36% of mothers and 11%-20% of fathers had a prescription of anxiolytics, hypnotics/sedatives or antidepressants. The corresponding percentages for non-bereaved mothers and fathers were 7%-12% and 4%-7%, respectively. Compared to non-bereaved mothers, bereaved mothers showed higher odds of prescriptions from 1 year before up to four (anxiolytics) and 5 years (hypnotics/sedatives and antidepressants) after the child's death. Bereaved fathers showed higher odds than non-bereaved fathers of prescriptions from 1 year before up to the year of (anxiolytics and hypnotics/sedatives) and 1 year after (antidepressants) the child's death. No differences in odds between bereaved and non-bereaved fathers were found at 2 years after the child's death. Being unmarried, born outside Sweden, and having a history of mental health problems were associated with higher odds of prescribed medications.

CONCLUSIONS

Indicative of mental health problems of clinical importance, cancer-bereaved parents had a higher prevalence of use of psychotropic medication. A decrease in medication use was evident with time, but still at 5 years after the child's death mothers displayed a higher use while fathers showed no difference to non-bereaved fathers after 2 years.

摘要

目的

研究父母失去青春期诊断为癌症的孩子后短期和长期使用精神药物的风险。

方法

这是一项瑞典全国性的基于登记的研究,包括 184 名丧子的母亲和 184 名丧子的父亲,这些孩子在青春期被诊断患有癌症。使用逻辑回归分析,调整社会人口统计学特征和精神健康问题史,来估计癌症丧亲父母在孩子去世前 1 年至 5 年内使用精神药物(抗焦虑药、催眠/镇静剂、抗抑郁药)的风险,以非丧亲父母(n=3291)为参照。

结果

在孩子去世的那一年,28%-36%的母亲和 11%-20%的父亲开了抗焦虑药、催眠/镇静剂或抗抑郁药。相应的非丧亲母亲和父亲的百分比分别为 7%-12%和 4%-7%。与非丧亲母亲相比,丧亲母亲在孩子去世前 1 年至 4 年(抗焦虑药)和 5 年(催眠/镇静剂和抗抑郁药)后开处方的可能性更高。丧父比非丧父的父亲更有可能在孩子去世前 1 年(抗焦虑药和催眠/镇静剂)和 1 年后(抗抑郁药)开处方。在孩子去世后 2 年,丧亲父亲和非丧亲父亲的几率没有差异。未婚、在瑞典境外出生和有精神健康问题史与开处方药物的几率更高相关。

结论

表明有临床重要性的精神健康问题,癌症丧亲父母使用精神药物的患病率更高。随着时间的推移,用药量有所下降,但在孩子去世 5 年后,母亲的用药量仍较高,而父亲在孩子去世 2 年后与非丧亲父亲没有差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e15/10028064/c572e9af94c9/CAM4-12-6148-g001.jpg

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