Childhood psychopathology can predict antidepressant use in young adults

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There are a number of cross-sectional studies that investigate antidepressant use in teenagers and young adults.  These are interesting, but because they don’t tend to follow-up study participants prospectively over a long period of time, there is only so much we can learn from them.

However, now researchers in Finland have published a study that takes data from the Finnish Nationwide 1981 Birth Cohort, which allows them to study prospective associations with childhood psychiatric problems.  The study looks at the links between mental health problems experienced in childhood and the lifetime prevalence and costs of antidepressants by the age of 24 years.

The birth cohort contains 5,547 people and all of these individuals had the following information gathered at 8 years old:

  • Parent-reported conduct
  • Teacher-reported conduct
  • Hyperkinetic and emotional symptoms
  • Self-reported depressive symptoms
The cohort was linked to the National Prescription Register which provided the main outcome measure: lifetime information about purchases of antidepressants between the ages of 8 and 24 years. The researchers found that:
  • 8.8% of males and 13.8% of females had used antidepressants between age 13 and 24 years
  • Among males, conduct problems independently predicted later antidepressant use
  • In both genders, self-reported depressive symptoms and not living with both biological parents at 8 years old, independently predicted later antidepressant use
  • Significant gender interactions were found for conduct and hyperkinetic problems, indicating that more males who had these problems at age 8 have used antidepressants compared with females with the same problems.

The authors concluded:

Childhood psychopathology predicts use of antidepressants, but the type of childhood psychopathology predicting antidepressant use is different among males and females.

Gyllenberg D, Sourander A, Niemelä S, Helenius H, Sillanmäki L, Ristkari T, Piha J, Kumpulainen K, Tamminen T, Moilanen I, Almqvist F. Childhood predictors of use and costs of antidepressant medication by age 24 years: findings from the Finnish Nationwide 1981 Birth Cohort Study. J Am Acad Child Adolesc Psychiatry. 2011 Apr;50(4):406-15, 415.e1. Epub 2011 Mar 3. [PubMed abstract]

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