title: Childhood adversities predict strongly the use of psychotropic drugs in adulthood: a population-based cohort study of 24,284 Finns.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  The results highlight the effect of environmental factors during childhood on mental health and the need for early recognition of families at risk.
authors.affiliation: Research Department, Social Insurance Institution of Finland, Helsinki, Finland Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.
authors.forename: Karoliina
authors.initials: K
authors.lastname: Koskenvuo
authors.affiliation: Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Koskenvuo
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology* / Q000706:statistics & numerical data; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D002648:Child; D015331:Cohort Studies; D004243:Divorce / Q000523:psychology; D005192:Family Health; D005195:Family Relations / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D011203:Poverty / Q000523:psychology; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000627:therapeutic use*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: Life course epidemiology; Lifecourse / Childhood Circumstances; MENTAL HEALTH