Evidence map›Paper›PMID 37787995›Full record

ArticleJAMA network open2023

Psychotropic Medication Use in Children and Adolescents With Type 1 Diabetes.

Shengxin Liu, Tyra Lagerberg, Jonas F Ludvigsson, Mark J Taylor, Zheng Chang, Brian M D'Onofrio, Henrik Larsson, Paul Lichtenstein, Soffia Gudbjörnsdottir, Ralf Kuja-Halkola and 1 more

Open access · goldAbstract read
In one paragraph

Article in JAMA network open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 5 countries.

Shengxin LiuDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Tyra LagerbergDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Jonas F LudvigssonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Mark J TaylorDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Zheng ChangDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Brian M D'OnofrioDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Henrik LarssonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Paul LichtensteinDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Soffia GudbjörnsdottirSwedish National Diabetes Register, Centre of Registers, Gothenburg, Sweden.
Ralf Kuja-HalkolaDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Agnieszka ButwickaDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Karolinska Institutet · SEUniversity of Gothenburg · SEUniversity of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Children and adolescents with type 1 diabetes (T1D) face elevated risks of psychiatric disorders. Despite their nonnegligible adverse effects, psychotropic medications are a common cost-effective approach to alleviating psychiatric symptoms, but evidence regarding their dispensation to children and adolescents with T1D remains lacking. Objective: To examine the trends and patterns of psychotropic medication dispensation among children and adolescents with T1D in Sweden between 2006 and 2019. Design, Setting, and Participants: This cohort study used data from multiple Swedish registers. The main study cohort included children and adolescents residing in Sweden from 2006 to 2019 and was followed up until the earliest of December 31, 2019, 18th birthday, emigration, or death. Data analyses were conducted from November 1, 2022, to April 30, 2023. Exposures: Type 1 diabetes. Main Outcomes and Measures: The primary outcomes were trends and patterns of psychotropic medication dispensation (including antipsychotics, antidepressants, anxiolytics, hypnotics, mood stabilizers, and medications for attention-deficit/hyperactivity disorder [ADHD]), psychotropic medication initiation, and history of neurodevelopmental and psychiatric diagnosis. Cumulative incidence curves and Cox proportional hazard models were used to estimate the aggregated incidence and hazard ratios of medication initiation after diabetes onset. Results: Of 3 723 745 children and adolescents (1 896 199 boys [50.9%]), 13 200 (0.4%; 7242 boys [54.9%]) had T1D (median [IQR] age at diagnosis, 11.1 [7.6-14.7] years). Between 2006 and 2019, psychotropic medication dispensation increased from 0.85% (95% CI, 0.65%-1.10%) to 3.84% (3.11%-4.69%) among children and from 2.72% (95% CI, 2.15%-3.39%) to 13.54% (95% CI, 12.88%-14.23%) among adolescents with T1D, consistently higher than their peers without T1D. The most commonly dispensed medications included hypnotics, ADHD medications, anxiolytics, and selective serotonin reuptake inhibitors, and all exhibited increasing trends. For those with T1D, psychiatric care was the primary prescription source, and up to 50.1% of treatments lasted more than 12 months. In addition, children and adolescents with T1D showed higher cumulative incidence and hazard ratios of medication initiation after diabetes onset than their same-age and same-sex counterparts. Conclusions and Relevance: This cohort study found an increasing trend in psychotropic medication dispensation among children and adolescents with T1D from 2006 to 2019, persistently higher than those without T1D. These findings call for further in-depth investigations into the benefits and risks of psychotropic medications within this population and highlight the importance of integrating pediatric diabetes care and mental health care for early detection of psychological needs and careful monitoring of medication use.

Indexed as

Anti-Anxiety AgentsDiabetes Mellitus, Type 1AdolescentAntidepressive AgentsChildCohort StudiesHumansHypnotics and SedativesMalePsychotropic DrugsAnti-Anxiety AgentsAntidepressive AgentsHypnotics and SedativesPsychotropic Drugs

Identifiers

PMID37787995
PMCPMC10548296
OpenAlexW4387296685

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.