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抗抑郁药在美国青少年和年轻成年人中的配给:2016-2022 年。

Antidepressant Dispensing to US Adolescents and Young Adults: 2016-2022.

机构信息

Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan.

Departments of Medicine and Pediatrics, University of Chicago, Chicago, Illinois.

出版信息

Pediatrics. 2024 Mar 1;153(3). doi: 10.1542/peds.2023-064245.

Abstract

BACKGROUND

Mental health worsened in adolescents and young adults after the coronavirus disease 2019 (COVID-19) outbreak in March 2020, but whether antidepressant dispensing to this population changed is unknown.

METHODS

We identified antidepressant prescriptions dispensed to US individuals aged 12 to 25 years from 2016 to 2022 using the IQVIA Longitudinal Prescription Database, an all-payer national database. The outcome was the monthly antidepressant dispensing rate, defined as the monthly number of individuals with ≥1 dispensed antidepressant prescription per 100 000 people. We fitted linear segmented regression models assessing for level or slope changes during March 2020 and conducted subgroup analyses by sex and age group.

RESULTS

Between January 2016 and December 2022, the monthly antidepressant dispensing rate increased 66.3%, from 2575.9 to 4284.8. Before March 2020, this rate increased by 17.0 per month (95% confidence interval: 15.2 to 18.8). The COVID-19 outbreak was not associated with a level change but was associated with a slope increase of 10.8 per month (95% confidence interval: 4.9 to 16.7). The monthly antidepressant dispensing rate increased 63.5% faster from March 2020 onwards compared with beforehand. In subgroup analyses, this rate increased 129.6% and 56.5% faster from March 2020 onwards compared with beforehand among females aged 12 to 17 years and 18 to 25 years, respectively. In contrast, the outbreak was associated with a level decrease among males aged 12 to 17 years and was not associated with a level or slope change among males aged 18 to 25 years.

CONCLUSIONS

Antidepressant dispensing to adolescents and young adults was rising before the COVID-19 outbreak and rose 63.5% faster afterward. This change was driven by increased antidepressant dispensing to females and occurred despite decreased dispensing to male adolescents.

摘要

背景

2020 年 3 月新冠肺炎(COVID-19)疫情爆发后,青少年和年轻人的心理健康状况恶化,但这一人群的抗抑郁药配给是否发生变化尚不清楚。

方法

我们使用 IQVIA 纵向处方数据库(一个全民付费的全国性数据库),确定了 2016 年至 2022 年期间美国 12 至 25 岁人群的抗抑郁药处方。结果是每月抗抑郁药配给率,定义为每 10 万人中至少有 1 人配给抗抑郁药处方的每月人数。我们拟合了线性分段回归模型,以评估 2020 年 3 月期间的水平或斜率变化,并按性别和年龄组进行了亚组分析。

结果

在 2016 年 1 月至 2022 年 12 月期间,每月抗抑郁药配给率增加了 66.3%,从 2575.9 增加到 4284.8。在 2020 年 3 月之前,这一比率每月增加 17.0(95%置信区间:15.2 至 18.8)。COVID-19 疫情的爆发与水平变化无关,但与每月增加 10.8 的斜率有关(95%置信区间:4.9 至 16.7)。从 2020 年 3 月开始,每月抗抑郁药配给率的增长速度比之前快了 63.5%。在亚组分析中,12 至 17 岁和 18 至 25 岁的女性从 2020 年 3 月开始,每月的抗抑郁药配给率分别比之前快了 129.6%和 56.5%。相比之下,在 12 至 17 岁的男性中,疫情的爆发与水平下降有关,而在 18 至 25 岁的男性中,疫情的爆发与水平或斜率变化均无关。

结论

在 COVID-19 疫情爆发之前,青少年和年轻人的抗抑郁药配给量就在上升,之后上升速度加快了 63.5%。这一变化的原因是女性抗抑郁药配给量的增加,尽管青少年男性的配给量有所减少。

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