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Seasonal trends in antidepressant prescribing and mental health diagnoses in adolescents and young adults

Status

Completed

Title

Seasonal trends in antidepressant prescribing and mental health diagnoses in adolescents and young adults: study using UK primary care data

What were the objectives of the study?

The antidepressant drugs prescribed to adolescents for depression and anxiety are selective serotonin reuptake inhibitors, or SSRIs. Since 2005, SSRI prescribing has been increasing in adolescents in the UK. This increase may be because more young people are having problems like depression and anxiety, or because they are more likely to see their doctors about these issues. It could also be because it is getting harder to get appointments for other treatments, such as talking therapies. Different things like weather and seasons, or stressful periods associated with their education, for example starting a new school year or exams, could affect young people’s mental health. So far, there have been few studies examining seasonal patterns of these issues in adolescents, and there is no clear pattern when adults have been studied. We will investigate whether adolescents and young adults have different patterns over the year of antidepressant prescriptions, depression, anxiety, and self-harm. By understanding when there is a greater need for support for adolescents and young adults, this can help with planning and availability of appropriate resources.

How was the research done?

In this study we will use information about antidepressant prescribing, depression, anxiety and self-harm events between 2006 and 2019 from QResearch with identifying information removed. We will examine three age groups: 14-18 years, 19-23 years and 24-28 years, so we can see if young people in their final years at school have different patterns to young adults. We will look at monthly patterns in:
• overall SSRI antidepressants prescriptions,
• prescriptions of the three SSRI drugs that are most commonly prescribed in these age groups (fluoxetine, sertraline and citalopram),
• records of depression, anxiety and self-harm

Chief Investigator

Dr Ruth Jack

Lead Applicant Organisation Name

Sponsor

University of Oxford

Location of research

University of Nottingham

Date on which research approved

20-Apr-2020

Project reference ID

OX69

Generic ethics approval reference

18/EM/0400

Are all data accessed are in anonymised form?

Yes

Brief summary of the dataset to be released (including any sensitive data)

The primary care cohort from EMIS includes all males and females registered in England aged 14-28 years (inclusive) between 2006 and 2019. Variables include records of depression, anxiety and self-harm and SSRI antidepressants prescribed in primary care. Additional ethnicity information will be used from HES.

What were the main findings?

Seasonal trends in antidepressant prescribing, depression, anxiety, and self-harm in adolescents and young adults: an open cohort study using English primary care data
Dr Ruth Jack, Senior Research Fellow at the University of Nottingham

In recent years there has been an increase in mental health issues and antidepressant prescribing in children and young people, however specialist mental health services in the UK are currently struggling to meet these increased demands.  Members of a Young Person’s Advisory Group asked whether there are particular periods in the year when adolescents have more mental health issues.

Information from QResearch about antidepressant prescribing and mental health events between 2006 and 2019 was used. People were grouped into males and females in three age groups: 14-18 years (adolescents), 19-23 years and 24-28 years. The first record of depression, anxiety and self-harm, as well as the first antidepressant prescription if it was a selective serotonin reuptake inhibitor (SSRI) was included. Antidepressant prescribing, depression and anxiety incidence rates were higher in autumn months for adolescents, but not for the older groups. Recorded self-harm was lowest in August for adolescents, lower in July-December for 19-23-year-old females and stable throughout the year for the other groups. Support for adolescents around mental health issues from GPs and others should be focused during the autumn.

The study was funded by the NIHR School for Primary Care Research.

Implications and Impact

If we find these mental health issues are more common in particular months, GP practices and other settings (such as schools and colleges) can ensure there are sufficient resources, including appropriate staff, available at these peak times to support the appropriate age groups.

Funding Source

NIHR SPCR

Public Benefit Statement

Research Team

Dr Ruth Jack, University of Nottingham

Dr Rebecca Joseph, University of Nottingham

Prof Carol Coupland, University of Nottingham

Prof Julia Hippisley-Cox, University of Oxford

Prof Chris Hollis, University of Nottingham

Publications

  • Seasonal trends in antidepressant prescribing, depression, anxiety and self-harm in adolescents and young adults: an open cohort study using English primary care data
    Authors: Jack RH, Joseph RM, Hollis C, Hippisley-Cox J, Butler D, Waldram D, Coupland CAC
    Ref:
    https://mentalhealth.bmj.com/content/26/1/e300855.long
  • Importance of accurate and accessible recording of healthcare contacts in mental health
    Authors: Jack RH, Coupland CAC, Joseph RM, Hollis C, Morriss R, Knaggs RD, Cipriani A, Cortese S, Hippisley-Cox J
    Ref:
    https://link.springer.com/article/10.1186/s12916-023-03044-w

Press Releases

Access Type

Trusted Research Environment (TRE)

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