Increased risk of antidepressant use in childhood cancer survivors: a Danish population-based cohort study
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Increased risk of antidepressant use in childhood cancer survivors : a Danish population-based cohort study. / Lund, Lasse Wegener; Winther, J.F.; Cederkvist, L; Andersen, K K; Dalton, S O; Appel, C W; Rechnitzer, C.; Schmiegelow, K; Johansen, C.
In: European journal of cancer (Oxford, England : 1990), Vol. 51, No. 5, 03.2015, p. 675-84.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Increased risk of antidepressant use in childhood cancer survivors
T2 - a Danish population-based cohort study
AU - Lund, Lasse Wegener
AU - Winther, J.F.
AU - Cederkvist, L
AU - Andersen, K K
AU - Dalton, S O
AU - Appel, C W
AU - Rechnitzer, C.
AU - Schmiegelow, K
AU - Johansen, C
N1 - Copyright © 2015 Elsevier Ltd. All rights reserved.
PY - 2015/3
Y1 - 2015/3
N2 - AIM: Childhood cancer survivors are at risk of both somatic and mental late effects, but large population-based studies of depression are lacking.METHODS: Risk of antidepressant use was evaluated in a population-based cohort of 5452 Danish children treated for cancer in 1975-2009 by linkage to the National Prescription Drug Database, which worldwide is the oldest nationwide registry of prescription medication. Hazard ratios (HRs) for antidepressant use were estimated in a Cox proportional hazards model stratified on sex, with population comparisons as referents.RESULTS: Overall, childhood cancer survivors were at increased risk of having antidepressants prescribed (HR, 1.4; 95% confidence interval (CI), 1.3-1.5). The excess absolute risk of antidepressant use was 2.5 per 1000 person-years (95% CI, 1.7-3.3), equivalent to an excess of 2.5 survivors for every 100 survivors followed for 10years. Increased HRs of 30-50% were seen for survivors of cancers of all main groups (haematological malignancies, central nervous system (CNS) and solid tumors); the highest risk was among children treated with haematopoietic stem cell transplantation (HR, 1.9; 95% CI, 1.2-3.1). Our data suggested that the risk was most pronounced for children treated in the most recent calendar periods (test for interaction between cancer and calendar periods: P<0.001), especially for survivors of haematological cancers (P=0.007). Interaction analysis of the effect of parental socioeconomic position and psychiatric disease on the association between childhood cancer and antidepressant use indicated no modifying effect.CONCLUSION: Childhood cancer survivors should be followed-up for depression. Our results indicate an increasing need for follow-up especially in survivors treated by more recent, intensive anticancer treatment.
AB - AIM: Childhood cancer survivors are at risk of both somatic and mental late effects, but large population-based studies of depression are lacking.METHODS: Risk of antidepressant use was evaluated in a population-based cohort of 5452 Danish children treated for cancer in 1975-2009 by linkage to the National Prescription Drug Database, which worldwide is the oldest nationwide registry of prescription medication. Hazard ratios (HRs) for antidepressant use were estimated in a Cox proportional hazards model stratified on sex, with population comparisons as referents.RESULTS: Overall, childhood cancer survivors were at increased risk of having antidepressants prescribed (HR, 1.4; 95% confidence interval (CI), 1.3-1.5). The excess absolute risk of antidepressant use was 2.5 per 1000 person-years (95% CI, 1.7-3.3), equivalent to an excess of 2.5 survivors for every 100 survivors followed for 10years. Increased HRs of 30-50% were seen for survivors of cancers of all main groups (haematological malignancies, central nervous system (CNS) and solid tumors); the highest risk was among children treated with haematopoietic stem cell transplantation (HR, 1.9; 95% CI, 1.2-3.1). Our data suggested that the risk was most pronounced for children treated in the most recent calendar periods (test for interaction between cancer and calendar periods: P<0.001), especially for survivors of haematological cancers (P=0.007). Interaction analysis of the effect of parental socioeconomic position and psychiatric disease on the association between childhood cancer and antidepressant use indicated no modifying effect.CONCLUSION: Childhood cancer survivors should be followed-up for depression. Our results indicate an increasing need for follow-up especially in survivors treated by more recent, intensive anticancer treatment.
KW - Adolescent
KW - Adult
KW - Age Factors
KW - Antidepressive Agents
KW - Case-Control Studies
KW - Child
KW - Child, Preschool
KW - Cohort Studies
KW - Denmark
KW - Depression
KW - Drug Prescriptions
KW - Female
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Male
KW - Neoplasms
KW - Proportional Hazards Models
KW - Registries
KW - Risk Assessment
KW - Risk Factors
KW - Survivors
KW - Time Factors
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1016/j.ejca.2015.01.001
DO - 10.1016/j.ejca.2015.01.001
M3 - Journal article
C2 - 25677304
VL - 51
SP - 675
EP - 684
JO - European Journal of Cancer, Supplement
JF - European Journal of Cancer, Supplement
SN - 0959-8049
IS - 5
ER -
ID: 162685357