title: Antidepressant use among survivors of childhood, adolescent and young adult cancer: a report of the Childhood, Adolescent and Young Adult Cancer Survivor (CAYACS) Research Program.
abstract: BACKGROUND
  Although survivors of childhood, adolescent, and young adult (AYA) cancer are at risk for late psychological sequelae, it is unclear if they are more likely to be prescription antidepressant users than their peers.
  
  
  METHODS
  All 5-year survivors of childhood or AYA cancer diagnosed before age 25 years in British Columbia from 1970 to 1995 were identified. Those with complete follow-up in the provincial health insurance registry from 2001 to 2004 were included (n = 2,389). A birth-cohort and gender-matched set of population controls 10 times the size of the survivor group was randomly selected (n = 23,890). All prescriptions filled between 2001 and 2004 were identified through linkage to the provincial prescription drug administrative database. Logistic regression analyses determined the impact of cancer survivorship on the likelihood of ever filling an antidepressant prescription.
  
  
  RESULTS
  After adjusting for sociodemographic factors, survivors of childhood and AYA cancer were more likely to have filled an antidepressant prescription compared to controls (OR 1.21, 95% CI 1.09-1.35). Cancer survivors had an increased likelihood of using all categories of antidepressants, and of using drugs from two or more antidepressant categories, compared to peers (OR 1.31, 95% CI 1.11-1.55 [≥2 antidepressant categories]). Treatment was not a significant predictor of antidepressant use. Female survivors, those in young adulthood and those more than 20 years post-treatment had increased antidepressant use.
  
  
  CONCLUSIONS
  Survivors of childhood and AYA cancer are more likely to fill antidepressant prescriptions compared to peer controls. This may indirectly reflect an increased underlying prevalence of mental health conditions among survivors.
authors.affiliation: Division of Oncology, Hematology and Bone Marrow Transplant, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Deyell
authors.forename: Maria
authors.initials: M
authors.lastname: Lorenzi
authors.forename: Suli
authors.initials: S
authors.lastname: Ma
authors.forename: Shahrad R
authors.initials: SR
authors.lastname: Rassekh
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Collet
authors.forename: John J
authors.initials: JJ
authors.lastname: Spinelli
authors.forename: Mary L
authors.initials: ML
authors.lastname: McBride
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001955:British Columbia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents