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Risk for Use of Antidepressants, Anxiolytics and Hypnotics in Parents of Children Diagnosed with Cancer: A Population-Based Cohort Study

29 Pages Posted: 2 Aug 2018

See all articles by Hanin Salem

Hanin Salem

Danish Cancer Society, Danish Cancer Society Research Center, Unit of Survivorship

Elisabeth Wreford Andersen

Danish Cancer Society, Danish Cancer Society Research Center, Unit of Survivorship

Susanne O. Dalton

Danish Cancer Society, Danish Cancer Society Research Center, Unit of Survivorship

Kjeld Schmiegelow

University of Copenhagen - University Hospital Rigshospitalet

Jeanette Falck Winther

Danish Cancer Society - Childhood Cancer Research Group; Aarhus University - Department of Clinical Medicine

Wendy G. Lichtenthal

Memorial Sloan Kettering Cancer Center - Department of Psychiatry & Behavioral Sciences

Christoffer Johansen

Government of the Kingdom of Denmark - Department of Oncology

Pernille E. Bidstrup

Danish Cancer Society, Danish Cancer Society Research Center, Unit of Survivorship

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Abstract

Background: Experiencing cancer in a child may be stressful for the whole family. In a population-based cohort study, we investigated the psychological impact in terms of risk of psychotropic medication in the parents.
Methods: We examined the risk for first prescription of psychotropic medication (antidepressants, anxiolytics, or hypnotics) among all parents of children with cancer (N=6744) identified in the Danish Cancer Registry between 1998-2014 using matched parents of cancer-free children (N=65 421) as a comparison cohort. In Cox proportional hazard models, we estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for first prescription of psychotropic medication according to cancer status in the child. Further, to identify potential vulnerable sub-groups among parents of children with cancer, we followed all parents of children with cancer identified in the Childhood Cancer Registry between 2003-2015 (N = 3290 parents) and estimated HRs for first prescription of psychotropic medication according to education, income, cancer type, cancer relapse or death of the child.
Findings: Three years after diagnosis, parents of children with cancer had a 14% cumulative incidence (95% CI 13·6-15·3) of having a first prescription of any psychotropic medication compared to 10 % in of parents of cancer-free children. The risk was highest in the first year and was particularly high for anxiolytics (HR 2·99 CI 2·54-3·52) and hypnotics (HR 2·64 CI 2·26-3·09). Among parents of children with cancer, the highest risk was seen for hypnotics in parents who experienced the death of a child (HR 6·91 CI, 3·50-13·66) in the first year after diagnosis, but an increased risk was also seen according to relapse, education, and income.
Interpretation: Increased use of psychotropic drugs among parents to children with cancer emphasizes the need for psychological support to prevent psychiatric morbidity so severe as to require medical treatment.
Funding: Danish Childhood Cancer Foundation.
Conflict of Interests: The authors declare no potential conflict of interest.
Ethical Approval Statement: The study approved by the Danish Data protection Agency (No. 2014-41-3405). Research based solely on registry data are exempt from ethical approval as well as from informed consent according to Danish law.

Keywords: antidepressants, anxiolytics, hypnotics, psychotropic medicine, childhood cancer, parents, cohort study, distress

Suggested Citation

Salem, Hanin and Andersen, Elisabeth Wreford and Dalton, Susanne O. and Schmiegelow, Kjeld and Winther, Jeanette Falck and Lichtenthal, Wendy G. and Johansen, Christoffer and Bidstrup, Pernille E., Risk for Use of Antidepressants, Anxiolytics and Hypnotics in Parents of Children Diagnosed with Cancer: A Population-Based Cohort Study (June 26, 2018). Available at SSRN: https://ssrn.com/abstract=3204734

Hanin Salem (Contact Author)

Danish Cancer Society, Danish Cancer Society Research Center, Unit of Survivorship ( email )

Denmark

Elisabeth Wreford Andersen

Danish Cancer Society, Danish Cancer Society Research Center, Unit of Survivorship

Denmark

Susanne O. Dalton

Danish Cancer Society, Danish Cancer Society Research Center, Unit of Survivorship

Denmark

Kjeld Schmiegelow

University of Copenhagen - University Hospital Rigshospitalet

Denmark

Jeanette Falck Winther

Danish Cancer Society - Childhood Cancer Research Group

Denmark

Aarhus University - Department of Clinical Medicine

Denmark

Wendy G. Lichtenthal

Memorial Sloan Kettering Cancer Center - Department of Psychiatry & Behavioral Sciences

United States

Christoffer Johansen

Government of the Kingdom of Denmark - Department of Oncology

Denmark

Pernille E. Bidstrup

Danish Cancer Society, Danish Cancer Society Research Center, Unit of Survivorship

Denmark

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