Educational and health outcomes of children and adolescents receiving antidepressant medication: Scotland-wide retrospective record linkage cohort study of 766 237 schoolchildren.
Educational and health outcomes of children and adolescents receiving antidepressant medication: Scotland-wide retrospective record linkage cohort study of 766 237 schoolchildren.
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DOI：
10.1093/ije/dyaa002
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发表时间：
2020-08-01
影响因子：
7.7
通讯作者：
Pell JP
中科院分区：
文献类型：
--
作者：
Fleming M;Fitton CA;Steiner MFC;McLay JS;Clark D;King A;Mackay DF;Pell JP
儿童抑郁症相对常见，研究不足，会影响社交和认知功能以及自尊。例行收集的苏格兰范围行政数据库的记录链接，涵盖处方[处方信息系统 (PIS)]、住院（苏格兰发病率记录 01 和 04）、产妇记录（苏格兰发病率记录 02）、死亡（苏格兰国家记录）、年度学生普查、学校缺勤/开除、特殊教育需求（苏格兰教育数据交换；ScotXed）、考试（苏格兰发病率记录 02）资格管理局 (Qualifications Authority) 和 (un)employment (ScotXed) 提供了 2009 年至 2013 年期间在苏格兰学校就读的 766 237 名儿童的数据。我们将接受抗抑郁药物治疗的儿童与同龄人的教育和健康结果进行了比较，调整了混杂因素（社会人口、生育和合并症），并探索了影响调节因素和调节因素。与同龄人相比，接受抗抑郁药物治疗的儿童更有可能缺课[调整后发病率比 (IRR) 1.90，95% 置信区间 (CI) 1.85–1.95] 或被学校开除（调整后 IRR 1.48，95% CI 1.29–1.69），有特殊教育需求 [调整后比值比 (OR) 1.77，95% CI] 1.65–1.90]，学业成绩最低（调整后 OR 3.00，95% CI 2.51–3.58），毕业后失业（调整后 OR 1.88，95% CI 1.71–2.08）。 5 年随访期间，他们的住院率 [调整后风险比 (HR) 2.07，95% CI 1.98–2.18] 和死亡率（调整后 HR 2.73，95% CI 1.73–4.29）增加。较高的缺勤率部分解释了较差的学习成绩和失业率。男孩中接受抗抑郁药物治疗的比例低于女孩（0.5% vs 1.0%），但男孩中与特殊教育需求和失业的相关性更强。接受抗抑郁药物治疗的儿童在教育和健康方面的表现都比同龄人差。应研究减少缺勤或减轻缺勤影响的干预措施。
Childhood depression is relatively common, under-researched and can impact social and cognitive function and self-esteem. Record linkage of routinely collected Scotland-wide administrative databases covering prescriptions [prescribing information system (PIS)], hospitalizations (Scottish Morbidity Records 01 and 04), maternity records (Scottish Morbidity Records 02), deaths (National Records of Scotland), annual pupil census, school absences/exclusions, special educational needs (Scottish Exchange of Educational Data; ScotXed), examinations (Scottish Qualifications Authority) and (un)employment (ScotXed) provided data on 766 237 children attending Scottish schools between 2009 and 2013 inclusively. We compared educational and health outcomes of children receiving antidepressant medication with their peers, adjusting for confounders (socio-demographic, maternity and comorbidity) and explored effect modifiers and mediators. Compared with peers, children receiving antidepressants were more likely to be absent [adjusted incidence rate ratio (IRR) 1.90, 95% confidence interval (CI) 1.85–1.95] or excluded (adjusted IRR 1.48, 95% CI 1.29–1.69) from school, have special educational needs [adjusted odds ratio (OR) 1.77, 95% CI 1.65–1.90], have the lowest level of academic attainment (adjusted OR 3.00, 95% CI 2.51–3.58) and be unemployed after leaving school (adjusted OR 1.88, 95% CI 1.71–2.08). They had increased hospitalization [adjusted hazard ratio (HR) 2.07, 95% CI 1.98–2.18] and mortality (adjusted HR 2.73, 95% CI 1.73–4.29) over 5 years’ follow-up. Higher absenteeism partially explained poorer attainment and unemployment. Treatment with antidepressants was less common among boys than girls (0.5% vs 1.0%) but the associations with special educational need and unemployment were stronger in boys. Children receiving antidepressants fare worse than their peers across a wide range of education and health outcomes. Interventions to reduce absenteeism or mitigate its effects should be investigated.
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DOI：
10.1111/j.1469-7610.2006.01682.x
发表时间：
2006-12-01
影响因子：
7.6
作者：
Costello, E. Jane;Erkanli, Alaattin;Angold, Adrian
通讯作者：
Angold, Adrian
DOI：
10.1111/1471-0528.12071
发表时间：
2013-02-01
影响因子：
5.8
作者：
Mackay, D. F.;Smith, G. C. S.;Pell, J. P.
通讯作者：
Pell, J. P.
影响因子：
15.8
作者：
MacKay DF;Smith GC;Dobbie R;Pell JP
通讯作者：
Pell JP
影响因子：
2.1
作者：
Fletcher, Jason M.
通讯作者：
Fletcher, Jason M.
影响因子：
5.6
作者：
Bachmann, Christian J.;Aagaard, Lise;Hoffmann, Falk
通讯作者：
Hoffmann, Falk