Persistent fear of a family member as a child is linked to a significantly increased use of drugs for mental health problems in adult life, indicates a study published online in the Journal of Epidemiology & Community Health.
The number of drugs used as an adult seems to correspond to the number of traumatic emotional events experienced by the child, the findings show.
The researchers used information from the Health and Social Support study in 1998 and its follow up in 2003-4 on a randomly selected sample (24,284) of the Finnish population between the ages of 20 and 54.
Participants were asked whether they had experienced any of the following six emotional traumas as a child: parental divorce/separation; long term financial problems; serious family conflict; frequent fear of a family member; severe illness and/or alcohol problems in a family member.
They were also asked to describe their relationships with their parents during childhood and adolescence, and provided information on educational attainment/training and employment.
Their use of psychotropic drugs, which includes drugs for psychosis, bipolar disorder, anxiety, antidepressants, sleeping pills, and sedatives, was tracked over a period of 9 years, using data collected by the National Drug Prescription Register.
This register contains information on all prescriptions issued by authorised doctors in the public and private sectors, occupational health and hospital outpatient clinics.
Results and Discussion:
Around a quarter of all participants had used at least one of these drugs, with antidepressants the most commonly used drug (17.6%). The drugs least likely to be used were those for bipolar disorder (2.4%) and psychosis (3.6%).
Just under one in 10 (9%) had used tranquillizers or sleeping pills and sedatives.
Analysis of the data showed that living in fear of a family member was most strongly associated with the use of psychotropic drugs.
People who experienced this as a child were three times as likely to have used several types of antidepressant and twice as likely to have used a range of psychotropic drugs.
People who experienced serious family conflicts while growing up were also twice as likely to use psychotropic drugs, while those who had experienced serious illness in the family were more likely to use drugs for psychosis and bipolar disorder.
But divorce/separation was only weakly linked to use of any psychotropic drug.
The findings also pointed to a graded response in drug use, with those who had experienced 5-6 of the listed emotional traumas around three times more likely to use psychotropic drugs than those who had experienced between 1 and 4, after taking account of influential factors.
And those experiencing multiple emotional traumas and who had a poor relationship with their mother were five times more likely to use psychotropic drugs than those who had had a care free childhood and got on well with their mothers.
The findings indicated that a good relationship with the mother helped to mitigate the effects of multiple trauma and lessen the likelihood of psychotropic drug use in adulthood.
This is an observational study so no direct conclusions can be drawn about cause and effect, but the authors say that their results “highlight the effect of harmful environmental factors during childhood on mental health problems,” and they emphasise the need to recognise at risk families early on.
Dr Karoliina Koskenvuo, Research Department, Social Insurance Institution of Finland, Helsinki, Finland.
Tel: +358 20 63 41 355; +358 50 30 29 054
Koskenvuo K, et al. Childhood adversities predict strongly the use of psychotropic drugs in adulthood: a population-based cohort study of 24 284 Finns. J Epidemiol Community Health 2014;0:1–7. doi:10.1136/jech-2014-204732
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