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- Berg, Venla, et al.
(author)
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Parental alcohol and drug abuse and offspring mortality by age 10 : a population-based register study
- 2022
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In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 32:6, s. 933-938
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Journal article (peer-reviewed)abstract
- BACKGROUND: Parental substance abuse (SA) of alcohol and drugs is associated with offspring mortality, including sudden infant death syndrome (SIDS), in infancy, but research on cause-specific mortality and mortality in later childhood is scarce.METHODS: Using population-based register data on all births in Sweden in 1973-2013 (N = 4.2 million) and Cox regressions, we examined the associations of mother's and father's SA registered between 2 years before and 12 years after the child birth with offspring all-cause and cause-specific mortality in infancy and childhood.RESULTS: Parental SA was associated with increased offspring all-cause and natural-cause mortality in infancy, but not in the neonatal period, and with external-cause mortality in ages 1-9. Risk of SIDS was 130-280% higher in infants with parental SA compared to infants with no parental SA. Adjusting for parental socioeconomic and immigrant status and severe psychiatric disorders, paternal SA was associated with 66% higher mortality due to communicable diseases and infections in infancy, and both maternal and paternal SA were associated with 40-174% higher mortality due to accidents in infancy and in ages 1-9. The associations between parental SA and offspring mortality were similar for male and female offspring.CONCLUSIONS: Child mortality is rare in contemporary Sweden, and parental SA has variable associations with elevated offspring mortality throughout the first 10 years of life, excluding the neonatal period, which is indicative of insufficient recognition of children at risk. Preventive measures should be long-term and targeted to both parental and offspring behaviour.
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| 2. |
- Virtanen, Suvi, et al.
(author)
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Association of selective serotonin reuptake inhibitor (SSRI) treatment with acute substance misuse outcomes
- 2022
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In: Addiction. - : Blackwell Publishing. - 0965-2140 .- 1360-0443. ; 117:1, s. 234-242
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Journal article (peer-reviewed)abstract
- BACKGROUND AND AIMS: Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed medications for patients with anxiety/depression. These patients often have problems with substance use, but it remains unclear whether the risk of substance misuse is influenced by SSRI treatment. We aimed to determine whether SSRI treatment is associated with a decreased risk of acute substance misuse-related outcomes.DESIGN: Cohort study following individuals through Swedish nationwide registers between July 2005 and December 2013 and comparing the risk of substance misuse outcomes during periods on- versus off-treatment within the same individual.SETTING: Swedish general population.PARTICIPANTS: Individuals with a new dispensed prescription of SSRIs between July 2006 and December 2013, and an ICD-10 diagnosis of anxiety/depressive disorder before the first treatment initiation. The cohort included 146,114 individuals (60.7% women).MEASUREMENTS: Substance misuse outcomes included ICD-10 diagnoses of acute intoxications (F10.0-F19.0), accidental poisonings by alcohol or drugs (X41-X42, X45-X46), and substance-related criminal offenses.FINDINGS: The absolute rate of substance misuse increased sharply before the onset of SSRI treatment and decreased after treatment initiation. Stratified Cox regression models showed an elevated risk (hazard ratio (HR)=1.70, 95% confidence interval (CI): 1.62-1.78) of substance misuse outcomes during a 1-month period preceding treatment initiation, compared with the reference period of more than 1 month before treatment start. The on-treatment estimates (1-30 days [HR=1.29, 95% CI: 1.23-1.37], 31-120 days [HR=1.30, 95% CI: 1.24-1.35], and >120 days [HR=1.24, 95% CI: 1.18-1.30] after treatment initiation) were consistently lower than the 1-month pre-treatment estimate, but still elevated compared with the reference period.CONCLUSIONS: For people with anxiety/depression, the risk of substance misuse appears to be particularly elevated right before initiating selective serotonin reuptake inhibitor (SSRI) treatment, which may reflect the emergence or worsening of substance use problems concurrently with anxiety/depression. SSRI treatment appears to be associated with a lower risk of substance misuse compared with the 1-month period preceding treatment initiation, but causality remains uncertain.
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