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- Taipale, Heidi, et al.
(författare)
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Initiation of antidepressant use among refugee and Swedish-born youth after diagnosis of a common mental disorder : findings from the REMAIN study
- 2021
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 56, s. 463-474
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The objective of this study was to compare the initiation and type of antidepressant use between refugees and matched Swedish-born youth after a diagnosis of a common mental disorder (CMD) and assess sociodemographic and clinical factors associated with the initiation.Methods The study cohort included youth aged 16-25 years, with an incident diagnosis of CMD based on specialized health care registers in Sweden 2006-2016, without prior antidepressant use during 1 year. One Swedish-born person was matched for each identified refugee youth (N = 3936 in both groups). Initiation of antidepressant use and factors associated with the initiation, were investigated with logistic regression yielding Odds ratios, OR, and 95% Confidence Intervals, CI.Results Refugees were less likely to initiate antidepressant use compared with Swedish-born (40.5% vs. 59.6%, adjusted OR 0.43, 95% CI 0.39-0.48). Selective serotonin reuptake inhibitors (SSRIs) were less frequently initiated for refugees than Swedish-born (71.2% vs. 81.3% of initiations,p < 0.0001). Sertraline was the most commonly initiated antidepressant both for refugees (34.3%) and Swedish-born individuals (40.3%). Among refugees, factors associated with increased odds of antidepressant initiation were previous use of anxiolytics or hypnotics, previous sickness absence of < 90 days, cancer and older age (OR range 1.07-2.72), and less than 5 years duration of residency in Sweden was associated with decreased odds (OR 0.76, 95% CI 0.63-0.92).Conclusion Young refugees with a CMD seem to initiate antidepressants in general and those most effective considerably less often than their Swedish-born counterparts.
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| 2. |
- Taipale, Heidi, et al.
(författare)
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Persistence of antidepressant use among refugee youth with common mental disorder
- 2021
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 294, s. 831-837
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Tidskriftsartikel (refereegranskat)abstract
- Background: The objective of this study was to investigate whether persistence of antidepressant use differs between refugee youth and Swedish-born youth after a diagnosis of a common mental disorder (CMD), and if clinical and sociodemographic factors are associated with antidepressant discontinuation.Methods: Youth aged 16-25 years, with an incident diagnosis of CMD (depression, post-traumatic stress disorder (PTSD), anxiety disorders) accessing specialized healthcare in Sweden 2006-2016 were included. New users were identified with a one-year washout period. Refugees (N=1575) were compared with Swedish-born youth (N=2319). Cox regression models [reported as adjusted Hazard Ratios (HRs) with 95% confidence intervals (CIs)] were used to investigate factors associated with discontinuation of antidepressant use.Results: Among youth (mean age 20.9 years, SD 2.7, 50% females), the median duration of antidepressant use differed considerably between refugee (101 days, IQR 31-243) and Swedish-born youth (252 days, IQR 101-558). Refugees were more likely to discontinue treatment (HR 1.61, 95% CI 1.47-1.77). Factors associated with an increased risk for discontinuation in refugees included ≤5 years duration of formal residency (HR 1.28, 95% CI 1.12-1.45), antidepressant type, and dispensing lag (time from prescription to dispensing) of >7 days (1.43, 1.25-1.64), whereas PTSD (0.78, 0.64-0.97) and anxiolytic use (0.79, 0.64-0.96) were associated with a lower discontinuation risk.Limitations: Only persons treated in specialized healthcare could be included.Conclusion: The relatively short treatment durations among refugee youth suggest that antidepressant treatment may not be optimal in CMD, and better monitoring of treatment as well as transcultural education of healthcare personnel are warranted.
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