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Antidepressant utilisation patterns and determinants of short-term and non-psychiatric use in the Finnish general adult population.

https://arctichealth.org/en/permalink/ahliterature158770
Source
J Affect Disord. 2008 Sep;110(1-2):94-105
Publication Type
Article
Date
Sep-2008
Author
Sinikka Sihvo
Erkki Isometsä
Olli Kiviruusu
Juha Hämäläinen
Jaana Suvisaari
Jonna Perälä
Sami Pirkola
Samuli Saarni
Jouko Lönnqvist
Author Affiliation
STAKES National Research and Development Centre for Welfare and Health, Helsinki, Finland. sinikka.sihvo@stakes.fi
Source
J Affect Disord. 2008 Sep;110(1-2):94-105
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Alcohol-Related Disorders - drug therapy - epidemiology
Antidepressive Agents - therapeutic use
Anxiety Disorders - drug therapy - epidemiology
Bipolar Disorder - drug therapy - epidemiology
Depressive Disorder - drug therapy - epidemiology
Depressive Disorder, Major - drug therapy - epidemiology
Disabled persons - statistics & numerical data
Drug Prescriptions - statistics & numerical data
Drug Utilization
Family Practice - statistics & numerical data
Female
Finland - epidemiology
Humans
Male
Mental Disorders - drug therapy - epidemiology
Mental Health Services - utilization
Middle Aged
Registries - statistics & numerical data
Single Person - statistics & numerical data
Abstract
The aim was to study utilisation patterns and determinants of antidepressant use in the general population >30 years, especially short-term use or use not related to known psychiatric morbidity.
Participants from a cross-sectional population-based Finnish Health 2000 Study (2000--2001) were linked with the National Prescription Register and National Care Register for Health Care. Within a representative sample (N=7112) of the adult population (>30 years), 12-month DSM-IV depressive, anxiety, and alcohol use disorders were assessed with the M-CIDI. Utilisation patterns of antidepressants were categorised to short-term, intermittent and continuous use. Factors predicting short-term use or use not related to known psychiatric morbidity were investigated.
Of Finnish adults 7.1% had used antidepressants in 2000, of which two-thirds reported a physician-diagnosed mental disorder; a third (35%) had major depressive or anxiety disorder during the previous 12 months. In terms of utilisation pattern, 43% were long-term users, 32% intermittent users and 26% short-term users. Short-term use was related to care by a general practitioner and having no known mental disorder. A quarter of all users had no known psychiatric morbidity. This type of user was most common among the older age groups, and inversely related to being single, on disability pension and using mental health services.
Not all psychiatric indications for antidepressant use could be explored.
Depression remains the main indication for antidepressant use. About a quarter of users had no known psychiatric indication and the indication remained unclear. Short-term and non-psychiatric use are more commonly prescribed for the elderly.
PubMed ID
18276016 View in PubMed
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Antipsychotic use in the elderly: shifting trends and increasing costs.

https://arctichealth.org/en/permalink/ahliterature173711
Source
Int J Geriatr Psychiatry. 2005 Aug;20(8):749-53
Publication Type
Article
Date
Aug-2005
Author
Mark Rapoport
Muhammad Mamdani
Kenneth I Shulman
Nathan Herrmann
Paula A Rochon
Author Affiliation
Sunnybrook and Women's College Health Sciences Centre Departments of Psychiatry, Toronto, Canada. mark.rapoport@sw.ca
Source
Int J Geriatr Psychiatry. 2005 Aug;20(8):749-53
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Aged
Antipsychotic Agents - economics - therapeutic use
Benzodiazepines - therapeutic use
Cross-Sectional Studies
Dibenzothiazepines - therapeutic use
Drug Costs
Humans
Mental Disorders - drug therapy - epidemiology
Ontario - epidemiology
Population Surveillance - methods
Risperidone - therapeutic use
Abstract
The purpose of this study was to assess trends in utilization and costs of antipsychotic drugs among a population of older adults over time, with respect to the prevalence of users, shifts in prescribing patterns, and related financial implications.
Cross-sectional time series of quarterly and annual antipsychotic utilization and cost were obtained from administrative databases for calendar years 1993 through 2002.
A population-based study of more than 1.4 million residents of the province of Ontario aged 65 years or older.
Data sources used included the Ontario Drug Benefits (ODB) database and Statistics Canada census data.
The prevalence of antipsychotic users increased by 34.8% over the study period from 2.2% at the beginning of 1993 to 3.0% of the elderly at the end of 2002 (p
PubMed ID
16035128 View in PubMed
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Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents.

https://arctichealth.org/en/permalink/ahliterature288095
Source
BMJ Open. 2016 06 03;6(6):e010004
Publication Type
Article
Date
06-03-2016
Author
Anna Oudin
Lennart Bråbäck
Daniel Oudin Åström
Magnus Strömgren
Bertil Forsberg
Source
BMJ Open. 2016 06 03;6(6):e010004
Date
06-03-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Air Pollution - adverse effects
Antipsychotic Agents - therapeutic use
Child
Drug Prescriptions - statistics & numerical data
Environmental Exposure - adverse effects
Environmental monitoring
Female
Follow-Up Studies
Humans
Incidence
Longitudinal Studies
Male
Mental Disorders - drug therapy - epidemiology
Proportional Hazards Models
Social Class
Sweden - epidemiology
Time Factors
Abstract
To investigate associations between exposure to air pollution and child and adolescent mental health.
Observational study.
Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5.
The entire population under 18 years of age in 4 major counties. We excluded cohort members whose parents had dispensed a medication in the same medication group since the start date of the register. The cohort size was 552 221.
Cox proportional hazards models to estimate HRs and their 95% CIs for the outcomes, adjusted for individual-level and group-level characteristics.
The average length of follow-up was 3.5 years, with an average number of events per 1000 cohort members of ~21. The mean annual level of NO2 was 9.8 µg/m(3). Children and adolescents living in areas with higher air pollution concentrations were more likely to have a dispensed medication for a psychiatric disorder during follow-up (HR=1.09, 95% CI 1.06 to 1.12, associated with a 10 µg/m(3) increase in NO2). The association with NO2 was clearly present in 3 out of 4 counties in the study area; however, no statistically significant heterogeneity was detected.
There may be a link between exposure to air pollution and dispensed medications for certain psychiatric disorders in children and adolescents even at the relatively low levels of air pollution in the study regions. The findings should be corroborated by others.
Notes
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PubMed ID
27259522 View in PubMed
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Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards.

https://arctichealth.org/en/permalink/ahliterature179741
Source
Int Psychogeriatr. 2004 Mar;16(1):61-74
Publication Type
Article
Date
Mar-2004
Author
K H Pitkala
J V Laurila
T E Strandberg
R S Tilvis
Author Affiliation
Department of Medicine, Geriatric Clinic, Helsinki University Hospital, Finland. kaisu.pitkala@hus.fi
Source
Int Psychogeriatr. 2004 Mar;16(1):61-74
Date
Mar-2004
Language
English
Publication Type
Article
Keywords
Acute Disease
Aged
Aged, 80 and over
Brain - pathology - physiopathology - radiography
Cross-Sectional Studies
Dementia - diagnosis - epidemiology - psychology
Electroencephalography
Finland - epidemiology
Health Services for the Aged
Hospitalization
Hospitals, Urban
Humans
Magnetic Resonance Imaging
Mental Disorders - drug therapy - epidemiology - psychology - rehabilitation
Neuropsychological Tests
Nursing Homes
Psychotropic Drugs - therapeutic use
Questionnaires
Reproducibility of Results
Tomography, X-Ray Computed
Abstract
To describe the prevalence of various psychiatric and behavioral symptoms among patients with dementia in nursing homes and acute geriatric wards and to investigate the administration of psychotropic medications to these patients.
425 consecutive patients (>70 years) in six acute geriatric wards in two city hospitals and seven nursing homes in Helsinki, Finland, were assessed with an extensive interview, cognitive tests, and attention tests. Of these, 255 were judged to have dementia according to the following information: previous dementia diagnoses and their adequacy, results of CT scans, Mini-mental State Examination (MMSE) tests, Clinical Dementia Scale (CDR) tests, and DSM-IV criteria. Psychiatric and behavioral symptoms were recorded over two weeks for each patient.
Psychiatric and behavioral symptoms were very common among patients with dementia in both settings. In all, 48% presented with psychotic symptoms (delusions, visual or auditory hallucinations, misidentifications or paranoid symptoms), 43% with depression, 26% agitation, and 26% apathy. Use of psychotropic drugs was also common: 87% were on at least one psychotropic drug, 66% took at least two, 36% at least three, and 11% four or more psychotropic drugs. Of the patients with dementia, 42% were on conventional antipsychotics, and 34% on anxiolytics despite their known side-effects. Only 13% were on atypical antipsychotics and 3% on cholinesterase inhibitors. The use of selective serotonin reuptake inhibitors (SSRIs) was common (31%) among the patients. A surprising finding was that drugs with anticholinergic effects were also frequently (20%) used.
Both behavioural symptoms and use of psychotropic drugs are very common among dementia patients in institutional settings. The frequent use of potentially harmful drugs implies a need for education among physicians taking care of these patients.
PubMed ID
15190997 View in PubMed
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Can morbidity be inferred from prescription drug use? Results from a nation-wide prison population study.

https://arctichealth.org/en/permalink/ahliterature83317
Source
Eur J Epidemiol. 2005;20(7):587-92
Publication Type
Article
Date
2005
Author
Kjelsberg Ellen
Hartvig Paal
Author Affiliation
Centre for Research and Education in Forensic Psychiatry, Ulleval University Hospital, Oslo, Norway. ellen.kjelsberg@kompetanse-senteret.no
Source
Eur J Epidemiol. 2005;20(7):587-92
Date
2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Chronic Disease
Comorbidity
Drug Utilization - statistics & numerical data
Female
Humans
Male
Medical Records
Mental Disorders - drug therapy - epidemiology
Middle Aged
Morbidity
Norway - epidemiology
Pain - drug therapy - epidemiology
Prescriptions, Drug - statistics & numerical data
Prisoners - statistics & numerical data
Sex Distribution
Somatoform Disorders - drug therapy - epidemiology
Abstract
AIM: To estimate psychiatric and somatic morbidity in a nation-wide prison population, as inferred from detailed medication sheets. METHOD: Medication sheets from 37 prisons, covering 90% of the Norwegian prison population, were collected and examined by experienced clinicians. All inmates on medication were assigned best-estimate psychiatric and/or somatic diagnoses according to the International Classification of Primary Care diagnostic system. RESULTS: Among the 2617 inmates 919 (35%) had psychiatric disorders, as estimated by our methodology. Depressive disorders (11%) and sleep disorders (11%) were most prevalent. Twenty-six inmates (1%) were prescribed medication indicative of affective psychosis and an additional 77 (3%) received anti-psychotic drugs in doses indicating other psychotic disorders, bringing the sum total of psychosis up to 103 (4%). A total of 848 inmates (32%) were estimated to suffer from somatic disorders. Various pain conditions were prevalent (11%) in addition to obstructive airway diseases and asthma (4%). Both psychiatric and somatic disorders were more prevalent in female prisoners. CONCLUSION: This study has demonstrated high psychiatric and somatic morbidity in a nation-wide population of prison inmates receiving adequate health services. As the morbidity estimates are inferred from prescription drug use they must be interpreted with caution. However, we do believe that our study, utilizing this unconventional but readily available source of information, has yielded valuable knowledge regarding the physical and mental health of a nation-wide prison population.
PubMed ID
16119431 View in PubMed
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Changes between 1982 and 2000 in the prevalence of behavioral symptoms and psychotropic drug treatment among old people with cognitive impairment in geriatric care.

https://arctichealth.org/en/permalink/ahliterature95184
Source
Int Psychogeriatr. 2009 Oct;21(5):941-8
Publication Type
Article
Date
Oct-2009
Author
Lövheim Hugo
Sandman Per-Olof
Karlsson Stig
Gustafson Yngve
Author Affiliation
Department of Community Medicine and Rehabilitation, Umeå University, Sweden. hugo.lovheim@germed.umu.se
Source
Int Psychogeriatr. 2009 Oct;21(5):941-8
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aggression - drug effects
Alzheimer Disease - drug therapy - epidemiology
Anti-Anxiety Agents - adverse effects - therapeutic use
Antidepressive Agents - adverse effects - therapeutic use
Antipsychotic Agents - adverse effects - therapeutic use
Cross-Sectional Studies
Drug Utilization - statistics & numerical data - trends
Female
Health Surveys
Homes for the Aged - statistics & numerical data
Humans
Hypnotics and Sedatives - adverse effects - therapeutic use
Male
Mental Disorders - drug therapy - epidemiology
Nursing Homes - statistics & numerical data
Psychotropic Drugs - adverse effects - therapeutic use
Residential Facilities - statistics & numerical data
Sweden
Treatment Outcome
Abstract
BACKGROUND: People with a dementia disorder often live in institutional care facilities, particularly when the dementia disorder becomes severe or complicated by various behavioral disturbances. The aim of the present study was to analyze and compare the one-week prevalence of various behavioral symptoms and psychotropic drug treatment among people with cognitive impairment living in institutional care, in two large, comparable samples from 1982 and 2000. METHODS: A comparison was made between two cross-sectional samples, collected in 1982 and 2000 respectively, comprising 3404 participants with cognitive impairment living in geriatric care units in the county of Västerbotten, Sweden. Behavioral symptoms were measured using the Multi-Dimensional Dementia Assessment Scale (MDDAS) and cognition was measured using Gottfries' cognitive scale. RESULTS: Eight out of 25 behavioral symptoms had become less common, and six more common, after controlling for demographic changes. Regressive behavior, resistance to care and passiveness became less common, while certain aberrant motor behaviors showed an increased prevalence. Antidepressant drug use increased from 6.8% to 43.2%, antipsychotic drug use decreased from 38.0% to 26.2% and anxiolytics, hypnotic and sedative drug use increased from 12.7% to 38.5%. CONCLUSION: One-week prevalence of regressive symptoms and resistance to care had decreased and there were signs of a generally increased activity level among old people with cognitive impairment living in institutional geriatric care in 2000 compared to 1982. These changes may be an effect of the extensive changes in pharmacological treatments and in the organization of institutional geriatric care.
PubMed ID
19586566 View in PubMed
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Changes in prescription of antidepressants and disability pension due to back pain, compared with other musculoskeletal and other somatic diagnoses: a cohort study in Sweden.

https://arctichealth.org/en/permalink/ahliterature308978
Source
BMJ Open. 2019 09 17; 9(9):e029836
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
09-17-2019
Author
Annina Ropponen
Syed Ghulam Rahman
Pia Svedberg
Magnus Helgesson
Thomas Ernst Dorner
Ellenor Mittendorfer-Rutz
Author Affiliation
Finnish Institute of Occupational Health, Helsinki, Finland.
Source
BMJ Open. 2019 09 17; 9(9):e029836
Date
09-17-2019
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Antidepressive Agents - therapeutic use
Cohort Studies
Comorbidity
Drug Prescriptions - statistics & numerical data
Female
Humans
Insurance, Disability - statistics & numerical data
Logistic Models
Low Back Pain - epidemiology
Male
Mental Disorders - drug therapy - epidemiology
Middle Aged
Musculoskeletal Diseases - epidemiology
Pensions - statistics & numerical data
Registries
Risk factors
Somatoform Disorders - epidemiology
Sweden - epidemiology
Young Adult
Abstract
The aim was to investigate differences in the prescription of antidepressants during the transition to disability pension (DP) comparing DP due to back pain with DP due to other musculoskeletal and DP due to other somatic diagnoses.
A population-based cohort study with follow-up 3?years before and after the event. Estimated prevalence and adjusted ORs with 95% CIs for antidepressant prescription were computed for the 7-year window (ie, t-3 to t+3) around the DP by generalised estimating equations for repeated measures.
This Swedish population-based nationwide study with registry data included individuals aged 18-64 years, with DP due to back pain (n=2011), DP due to other musculoskeletal (n=3548) or DP due to other somatic diagnoses (n=11 809).
Prescription of antidepressants.
Before DP, the prevalence of prescription of antidepressants was stable in DP due to back pain, but increased for the other DP groups. Similarly, the likelihood of prescription increased only marginally before DP due to back pain (ORs from 0.86 at t-3 to 1.10 at t-1), but clearly in DP due to musculoskeletal (from 0.42 to 1.15) and somatic diagnoses (from 0.29 to 0.98). Both prevalence measures and risks remained at the elevated levels after DP.
Pathways to DP due to musculoskeletal and somatic diagnoses seem to be partly driven by adverse mental health, which remains at a higher level after DP. The increasing prescription of antidepressants prior to DP suggests that special attention should be paid to mental health for prevention of DP. The period after DP needs attention to avoid deterioration of mental health.
PubMed ID
31530605 View in PubMed
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Childhood adversities predict strongly the use of psychotropic drugs in adulthood: a population-based cohort study of 24,284 Finns.

https://arctichealth.org/en/permalink/ahliterature268779
Source
J Epidemiol Community Health. 2015 Apr;69(4):354-60
Publication Type
Article
Date
Apr-2015
Author
Karoliina Koskenvuo
Markku Koskenvuo
Source
J Epidemiol Community Health. 2015 Apr;69(4):354-60
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Adult
Adult Survivors of Child Adverse Events - psychology - statistics & numerical data
Alcohol Drinking - epidemiology - psychology
Child
Cohort Studies
Divorce - psychology
Family Health
Family Relations - psychology
Fear - psychology
Female
Finland - epidemiology
Follow-Up Studies
Health Surveys
Humans
Logistic Models
Male
Mental Disorders - drug therapy - epidemiology - etiology
Middle Aged
Poverty - psychology
Psychotropic Drugs - administration & dosage - therapeutic use
Risk factors
Smoking - epidemiology - psychology
Young Adult
Abstract
Exposure to adverse childhood experiences has been shown to be associated with negative health outcomes including mental health problems, but only a few studies with register-based data have used psychotropic drugs as an outcome variable. The purpose of this study is to examine whether adverse emotional childhood experiences, such as serious conflicts in the family and frequent fear of a family member, predict the use of psychotropic drugs in adulthood. In addition, the association of a child-parent relationship during childhood with the use of psychotropic drugs is studied.
The participants of the population-based Health and Social Support Study (24,284 working aged Finns) were followed up for 9 years. The information on childhood experiences and child-parent relationships was obtained from the questionnaires in 1998 and 2003. The number of psychotropic purchases (antipsychotics, drugs for bipolar disorder, antidepressants, anxiolytics, hypnotics and sedatives) was obtained from the National-Drug-Prescription-Register. Logistic and multinomial regression models were used.
A graded association between childhood adversities and the use of psychotropic drugs was found, even after adjustments for occupational training, work status, recent life events and health behaviour. Frequent fear of a family member showed the strongest association: the OR for multiple use of antidepressants was 3.08 (95% CI 2.72 to 3.49) and 2.69 (2.27 to 3.20) for multiple use of anxiolytics. Use of psychotropic drugs was clearly increased among those with poor child-parent relationship and multiple childhood adversities.
The results highlight the effect of environmental factors during childhood on mental health and the need for early recognition of families at risk.
PubMed ID
25538256 View in PubMed
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Childhood predictors of antipsychotic use among young people in Finland.

https://arctichealth.org/en/permalink/ahliterature125500
Source
Pharmacoepidemiol Drug Saf. 2012 Sep;21(9):964-71
Publication Type
Article
Date
Sep-2012
Author
David Gyllenberg
Andre Sourander
Hans Helenius
Lauri Sillanmäki
Jukka Huttunen
Jorma Piha
Kirsti Kumpulainen
Tuula Tamminen
Irma Moilanen
Fredrik Almqvist
Author Affiliation
Department of Child Psychiatry, University of Helsinki and Helsinki University Central Hospital, Finland. david.gyllenberg@helsinki.fi
Source
Pharmacoepidemiol Drug Saf. 2012 Sep;21(9):964-71
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Antipsychotic Agents - administration & dosage - therapeutic use
Child
Female
Finland - epidemiology
Follow-Up Studies
Hospitalization
Humans
Longitudinal Studies
Male
Mental Disorders - drug therapy - epidemiology - physiopathology
Mood Disorders - drug therapy - epidemiology
Psychotic Disorders - drug therapy - epidemiology
Registries
Sex Factors
Young Adult
Abstract
Information on who uses antipsychotic medication is limited to cross-sectional data. The objective of this study was to study the patterns of psychopathology at age 8?years and antipsychotic use between the ages of 12 and 25?years.
A total of 5525 subjects from the Finnish Nationwide 1981 birth cohort were linked to the National Prescription Register and the Hospital Discharge Register between 1994 and 2005. Information about parent-reported and teacher-reported conduct, hyperkinetic and emotional symptoms, and self-reported depressive symptoms was gathered at age 8?years. Information about antipsychotic use and about psychiatric disorders treated in hospitals between the ages of 12 and 25?years was register based. Diagnostic classes of hospital treatment included non-affective psychoses, affective disorders, and other psychiatric disorders.
The cumulative incidence of antipsychotic use by age 25?years was 2.8% among men (n?=?69) and 2.1% among women (n?=?55). In both sexes, living with other than two biological parents at age 8?years was associated with antipsychotic use, and three fourths of antipsychotic users had been treated for psychiatric disorders in a hospital. Among men, the most common hospital diagnosis was non-affective psychoses (44% of all antipsychotic users), and antipsychotic use was associated with childhood conduct problems. Among women, the most common hospital diagnosis was affective disorders (38% of all antipsychotic users), and antipsychotic use was associated with emotional problems and self-reported depressive symptoms in childhood.
Antipsychotic use in adolescence and young adulthood is different among men versus women both with regard to hospital diagnoses and childhood psychiatric problems.
PubMed ID
22473622 View in PubMed
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A comparative analysis of victims of sexual assault with and without mental health histories: acute and follow-up care characteristics.

https://arctichealth.org/en/permalink/ahliterature106504
Source
J Forensic Nurs. 2013 Apr-Jun;9(2):76-83
Publication Type
Article
Author
Rebecca Brown
Janice Du Mont
Sheila Macdonald
Deidre Bainbridge
Author Affiliation
Author Affiliations: 1Faculty of Medicine, University of Toronto 2Women's College Research Institute, Women's College Hospital, 3Dalla Lana School of Public Health at the University of Toronto, 4 Sexual Assault/Domestic Violence Care Centre at Women's College Hospital, 5Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto, and 6Sexual Assault/Domestic Violence Treatment Centres in Ontario.
Source
J Forensic Nurs. 2013 Apr-Jun;9(2):76-83
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Crime Victims - statistics & numerical data
Female
Humans
Male
Mental Disorders - drug therapy - epidemiology
Middle Aged
Ontario
Psychotropic Drugs - therapeutic use
Retrospective Studies
Sex Offenses
Young Adult
Abstract
Sexual assault is a common and serious health issue that is underreported and has low follow-up rates. The myriad of psychological sequelae of sexual assault are well documented; however, there is a dearth of literature on the prevalence of preexisting mental health issues in survivors of sexual assault. This exploratory study compares victims seen at a sexual assault treatment center with and without preexisting self-reported mental health histories. The rates of preexisting mental illness in sexual assault victims are significant. Implications for clinical practice and research are discussed.
PubMed ID
24158128 View in PubMed
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83 records – page 1 of 9.