Incidence of diagnosed pediatric anxiety disorders and use of prescription drugs: a nation-wide registry study
- 70 Downloads
The aim of this study was to calculate time trends in incidence of diagnosed anxiety disorders, including obsessive–compulsive disorder, and post-traumatic stress disorder, and to examine changes in use of prescribed drugs in the Norwegian pediatric population. Furthermore, we aimed to investigate whether comorbid mental disorders are associated with the use of prescribed drugs. Nation-wide registries with data from 2008 to 2015 were used, covering diagnostic data from primary health care [the Norwegian database for the control and reimbursement of health expenses (KUHR)] and secondary health care [the Norwegian Patient registry (NPR)], and data on prescribed drugs [the Norwegian prescription database, (NorPD)]. Data from the two latter were linked. During the period 2010–2015, 19,154 children and adolescents (61% girls) received a first diagnosis of anxiety disorders in primary care. The corresponding number from secondary care was 17,115 (61% girls). The incidence of diagnosed anxiety disorders increased over time, especially in girls, with an overall raise of ~ 2 per 1000 children across 2010–2015. Anti-anxiety drugs were used by < 12% of diagnosed children and < 25% of diagnosed adolescents, mainly by those with several contacts with the specialist health care system. There was no strong indications of an increase over time. Of other drugs, the most frequently prescribed were hypnotics and psychostimulants. Psychiatric comorbidity (33–55%) contributed to the use of drugs, including anti-anxiety drugs. The incidence of diagnosed anxiety disorders increased from 2010 to 2015, but the percentage using anti-anxiety drugs was stable. Drug use appears to be in line with the Norwegian guidelines.
KeywordsAnxiety disorders Prescription drugs Post-traumatic stress disorder Obsessive–compulsive disorder Comorbidity
Data from the Norwegian Patient Register have been used in this publication. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the Norwegian Patient Register is intended nor should be inferred. The authors are grateful to Vidar Hjellvik for preparing the registry data. The study was approved by The Regional Committee for Medical Research Ethics (2010/131) and by the Norwegian Data Protection Authority (10/00447-5).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no potential conflicts of interest.
- 6.Merikangas KR, He J-p, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J (2010) Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 49(10):980–989CrossRefGoogle Scholar
- 7.Craske MG (2003) Origins of phobias and anxiety disorders: why more women than men?. Elsevier, AmsterdamGoogle Scholar
- 10.Kessler RC, Angermeyer M, Anthony JC, De Graaf R, Demyttenaere K, Gasquet I, De Girolamo G, Gluzman S, Gureje O, Haro JM (2007) Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry 6(3):168PubMedPubMedCentralGoogle Scholar
- 13.Baldwin DS, Anderson IM, Nutt DJ, Allgulander C, Bandelow B, den Boer JA, Christmas DM, Davies S, Fineberg N, Lidbetter N (2014) Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology. J Psychopharmacol 28(5):403–439CrossRefGoogle Scholar
- 15.Norsk barne- og ungdomspsykiatrisk forening (2016) Diagnostikk i barne- og ungdomspsykiatri. https://legeforeningen.no/Fagmed/Norsk-barne--og-ungdomspsykiatrisk-forening/Faglig-veileder-for-barne-og-ungdomsspsykiatri/Del-2/f-40-41-angstlidelser/. Accessed 7 Aug 2019
- 16.Norsk Barnelegeforening (2018) Pediatriveiledere. https://www.helsebiblioteket.no/pediatriveiledere?menuitemkeylev1=5962&menuitemkeylev2=5975&key=144658. Accessed 7 Aug 2019
- 19.Ginsburg GS, Becker-Haimes EM, Keeton C, Kendall PC, Iyengar S, Sakolsky D, Albano AM, Peris T, Compton SN, Piacentini J (2018) Results from the child/adolescent anxiety multimodal extended long-term study (CAMELS): primary anxiety outcomes. J Am Acad Child Adolesc Psychiatry 57(7):471–480CrossRefGoogle Scholar
- 21.Garland EJ, Kutcher S, Virani A, Elbe D (2016) Update on the use of SSRIs and SNRIs with children and adolescents in clinical practice. J Can Acad Child Adolesc Psychiatry 25(1):4Google Scholar
- 26.Furu K (2008) Establishment of the nationwide Norwegian Prescription Database (NorPD)—new opportunities for research in pharmacoepidemiology in Norway. Norsk epidemiologi 18 (2)Google Scholar
- 27.Verbeke M, Schrans D, Deroose S, De Maeseneer J (2006) The International Classification of Primary Care (ICPC-2): an essential tool in the EPR of the GP. Stud Health Technol Inf 124:809Google Scholar
- 28.Omdl Santé, Organization WH, Staff W, WHO (1992) The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines, vol 1. World Health Organization, GenevaGoogle Scholar
- 32.Ollendick TH, Jarrett MA, Grills-Taquechel AE, Hovey LD, Wolff JC (2008) Comorbidity as a predictor and moderator of treatment outcome in youth with anxiety, affective, attention deficit/hyperactivity disorder, and oppositional/conduct disorders. Clin Psychol Rev 28(8):1447–1471CrossRefGoogle Scholar
- 36.Hayden EP, Mash EJ (2014) Child psychopathology: a developmental-systems perspective. In: Mash EJ, Barkley RA (eds) Child psychopathology. Guilford Publications, New York, USAGoogle Scholar