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- Hiyoshi, Ayako, 1972-, et al.
(författare)
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Stress resilience in adolescence and subsequent antidepressant and anxiolytic medication in middle aged men : Swedish cohort study
- 2015
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Ingår i: Social Science and Medicine. - Oxford, United Kingdom : Pergamon-Elsevier. - 0277-9536 .- 1873-5347. ; 134, s. 43-49
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Tidskriftsartikel (refereegranskat)abstract
- It is unclear whether psychological resilience to stress in adolescence represents a persistent characteristic relevant to the subsequent risk for depression and anxiety in later adulthood. We aimed to test whether low psychological stress resilience assessed in adolescence is associated with an increased risk of receiving medication for depression and anxiety in middle age. We utilized Swedish register-based cohort study. Men born between 1952 and 1956 (n = 175,699), who underwent compulsory assessment for military conscription in late adolescence were followed to examine subsequent risk of pharmaceutically-treated depression and anxiety in middle age, from 2006 to 2009 corresponding to ages between 50 and 58 years, using Cox regression. The associations of stress resilience with prescription of antidepressant and anxiolytics medication through potential mediating factors cognitive and physical function and adult socioeconomic factors were calculated. Low stress resilience was associated with elevated risks for antidepressant (hazard ratio (HR):1.5 (95% CI 1.4 1.6)) and anxiolytics (HR:2.4 (CI 2.0 2.7)) medication. Adjustment for measures of childhood living circumstances attenuated the associations somewhat. Around a third of association with low stress resilience, and a half of that with moderate resilience, was mediated through cognitive and physical function in adolescence and adult socioeconomic factors. The magnitude of the inverse association of higher cognitive function with antidepressant medication was eliminated among those with low stress resilience. These results indicate that low stress resilience in adolescence is associated with an increased risk for antidepressant and anxiolytics medication over 30 years later, in part mediated through developmental factors in adolescence and socioeconomic circumstances in adulthood, and low stress resilience can diminish or eliminate the inverse association of higher cognitive function with antidepressant medication.
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| 2. |
- Montgomery, Scott, et al.
(författare)
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Mortality following unemployment during an economic downturn : Swedish register-based cohort study
- 2013
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 3:7, s. e003031-
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate if unemployment during an economic downturn is associated with mortality, even among men with markers of better health (higher cognitive function scores and qualifications), and to assess whether the associations vary by age at unemployment. Design Longitudinal register-based cohort study. Setting Study entry was in 1990 and 2001 when Sweden was entering periods of significant economic contraction. Participants A representative sample of men from the general population (n=234782) born between 1952 and 1956 who participated in military conscription examinations. Men in receipt of disability or sickness benefit at study entry were excluded. Main outcome measure All-cause mortality. Results Unemployment compared with employment in 1991 (ages 34-38years) produced adjusted HRs (with 95% CIs) for all-cause mortality (3651 deaths) during follow-up to 2001 and after stratification by education of 2.35 (1.99 to 2.76) for compulsory education, 2.25 (1.97 to 2.58) for up to 3years postcompulsory education and 1.90 (1.40 to 2.57) for more than 3years postcompulsory education. When unemployment was compared with employment in 2001 (ages 45-49years) with follow-up to 2010, the pattern of mortality risk (4271 deaths) stratified by education was reversed, producing adjusted HRs of 2.81 (2.47 to 3.21) for compulsory education, 2.87 (2.58 to 3.19) for up to 3years postcompulsory education and 3.44 (2.78 to 4.25) for more than 3years postcompulsory education. Interaction testing confirmed effect modification by age/period (p=0.003). The degree of gradient reversal was slightly less pronounced after stratification by cognitive function but produced a similar pattern of results (p=0.004). Conclusions Unemployment at older ages is associated with greater mortality risk than at younger ages, with the greatest relative increase in risk among men with markers of better health, suggesting the greater vulnerability of all older workers to unemployment-associated exposures.
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