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Psychotropic Medica...
Psychotropic Medication Use in Children and Adolescents With Type 1 Diabetes
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- Liu, Shengxin (författare)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
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- Lagerberg, Tyra (författare)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
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- Ludvigsson, Jonas F., 1969- (författare)
- Karolinska Institutet,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
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- Taylor, Mark J. (författare)
- Karolinska Institutet
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- Chang, Zheng (författare)
- Karolinska Institutet
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- D'Onofrio, Brian M. (författare)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Psychological and Brain Sciences, Indiana University, Bloomington
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- Larsson, Henrik, 1975- (författare)
- Örebro universitet, Institutionen för medicinska vetenskaper,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
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- Lichtenstein, Paul (författare)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
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- Gudbjörnsdottir, Soffia, 1962 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Kuja-Halkola, Ralf (författare)
- Karolinska Institutet
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- Butwicka, Agnieszka (författare)
- Karolinska Institutet
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(creator_code:org_t)
- American Medical Association (AMA), 2023
- 2023
- Engelska.
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 6:10
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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https://gup.ub.gu.se...
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Abstract
Ämnesord
Stäng
- IMPORTANCE: Children and adolescents with type 1 diabetes (T1D) face elevated risks of psychiatric disorders. Despite their nonnegligible adverse effects, psychotropic medications are a common cost-effective approach to alleviating psychiatric symptoms, but evidence regarding their dispensation to children and adolescents with T1D remains lacking. OBJECTIVE: To examine the trends and patterns of psychotropic medication dispensation among children and adolescents with T1D in Sweden between 2006 and 2019.DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from multiple Swedish registers. The main study cohort included children and adolescents residing in Sweden from 2006 to 2019 and was followed up until the earliest of December 31, 2019, 18th birthday, emigration, or death. Data analyses were conducted from November 1, 2022, to April 30, 2023.EXPOSURES: Type 1 diabetes.MAIN OUTCOMES AND MEASURES: The primary outcomes were trends and patterns of psychotropic medication dispensation (including antipsychotics, antidepressants, anxiolytics, hypnotics, mood stabilizers, and medications for attention-deficit/hyperactivity disorder [ADHD]), psychotropic medication initiation, and history of neurodevelopmental and psychiatric diagnosis. Cumulative incidence curves and Cox proportional hazard models were used to estimate the aggregated incidence and hazard ratios of medication initiation after diabetes onset. RESULTS: Of 3 723 745 children and adolescents (1 896 199 boys [50.9%]), 13 200 (0.4%; 7242 boys [54.9%]) had T1D (median [IQR] age at diagnosis, 11.1 [7.6-14.7] years). Between 2006 and 2019, psychotropic medication dispensation increased from 0.85% (95% CI, 0.65%-1.10%) to 3.84% (3.11%-4.69%) among children and from 2.72% (95% CI, 2.15%-3.39%) to 13.54% (95% CI, 12.88%-14.23%) among adolescents with T1D, consistently higher than their peers without T1D. The most commonly dispensed medications included hypnotics, ADHD medications, anxiolytics, and selective serotonin reuptake inhibitors, and all exhibited increasing trends. For those with T1D, psychiatric care was the primary prescription source, and up to 50.1% of treatments lasted more than 12 months. In addition, children and adolescents with T1D showed higher cumulative incidence and hazard ratios of medication initiation after diabetes onset than their same-age and same-sex counterparts.CONCLUSIONS AND RELEVANCE: This cohort study found an increasing trend in psychotropic medication dispensation among children and adolescents with T1D from 2006 to 2019, persistently higher than those without T1D. These findings call for further in-depth investigations into the benefits and risks of psychotropic medications within this population and highlight the importance of integrating pediatric diabetes care and mental health care for early detection of psychological needs and careful monitoring of medication use.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
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Liu, Shengxin
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Lagerberg, Tyra
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Ludvigsson, Jona ...
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Taylor, Mark J.
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Chang, Zheng
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D'Onofrio, Brian ...
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Larsson, Henrik, ...
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Lichtenstein, Pa ...
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Gudbjörnsdottir, ...
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Kuja-Halkola, Ra ...
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Butwicka, Agnies ...
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Örebro universitet
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Karolinska Institutet
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Göteborgs universitet