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Fear of a family member in childhood is associated with use of prescription psychotropic drugs when older, study shows

BMJ 2014; 349 doi: (Published 23 December 2014) Cite this as: BMJ 2014;349:g7789
  1. Susan Mayor
  1. 1London

Adverse experiences in childhood, including persistent fear of a family member, are associated with significantly increased use of prescription psychotropic drugs when older, says a follow-up study that showed that improved recognition and help for families at risk might prevent future mental health problems.

The association between childhood adversities and adult mental health disorders is well established. But previous studies have looked at single childhood adversities, such as sexual abuse, or at single disorders, such as depression or psychosis. Few studies have looked at more general adverse experiences in childhood, such as serious conflicts in the family, or have assessed psychotropic drug use as an outcome measure of adult mental health problems.

Finnish researchers followed up 24 284 randomly selected people of working age (20-54) for nine years.1 The participants were asked about childhood experiences and their relationships with their parents in questionnaires in 1998 and 2003. Information on the use of psychotropic drugs, including antipsychotics, antidepressants, anxiolytics, and hypnotics, were obtained from Finland’s National Drug Prescription Register.

Around a quarter (24.3%) of study participants had used at least one prescribed psychotropic drug, and antidepressants were the most commonly used (17.6%). Results showed a graded association between childhood adversities and the use of psychotropic drugs, even after adjusting for recent life events, work status, and health behaviour.

Persistent fear of a family member as a child showed the strongest association, as people reporting this problem were three times more likely to have been given multiple courses of antidepressants than those who had not experienced this (odds ratio 3.08 (95% confidence interval 2.72 to 3.49)). They were also more than twice as likely to have had multiple courses of anxiolytics (2.69 (2.27 to 3.20)).

Further findings showed that people who experienced serious family conflicts while growing up were twice as likely to have used psychotropic drugs. But experience of parental divorce or separation during childhood was only weakly associated with the use of these drugs.

“The results highlight the effect of harmful environmental factors during childhood on mental health problems,” said the researchers, led by Karoliina Koskenvuo of the Social Insurance Institution of Finland in Helsinki. “They emphasise the importance of early recognition of families at risk and preventive measures against serious conflicts and adverse circumstances in the family,” they concluded.


Cite this as: BMJ 2014;349:g7789


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