title: Psychotropic drug use in adolescents born with an orofacial cleft: a population-based study.
abstract: OBJECTIVE
  Being born with an orofacial cleft (OFC) can, due to an incomplete closure of the lip and/or palate, convey a deviant speech and/or deviant facial aesthetics, which may in turn increase the risk for poor psychological health later in life. Previous investigations have been based on small samples and self-reports, not distinguishing between the three different types of OFC: cleft lip (CL), CL and palate (CLP) and cleft palate only (CPO). We present a large population-based study, considering psychotropic drug use as a proxy for poor psychological health and distinguishing between three different types of OFC.
  
  
  METHODS
  Using the Swedish Medical Birth Register, and linking to it the Swedish Prescribed Drug Register, the National Mortality Register, the Emigration Register and the National Inpatient Register, we identified all singletons born to native mothers in Sweden between 1987 and 1993, alive and residing in Sweden at the end of an 18-year follow-up period (N=626 109). We compared psychotropic drug use among individuals with and without OFC during the individuals' adolescence (2005-2008) by multiple logistic regressions, using ORs with 95% CIs.
  
  
  RESULTS
  When adjusted for potential confounders, having a CL (OR=1.63, 95% CI 1.08 to 2.46) or a CPO (OR=1.54, 95% CI 1.18 to 2.01) increased the risk of psychotropic drug use. Results were not significant regarding adolescents who had a CLP (OR=1.21, 95% CI 0.81 to 1.80).
  
  
  CONCLUSIONS
  Being born with a CL or a CPO increases the risk for psychotropic drug use in adolescence, but not for adolescents born with a CLP. Our findings suggest that, since the three OFC types are associated with different long-term risks of poor psychological health, the three groups should be studied separately concerning long-term psychosocial consequences.
authors.affiliation: Unit for Social Epidemiology, Faculty of Medicine, Lund University, Malmö, Sweden.
authors.forename: Sofia
authors.initials: S
authors.lastname: Nilsson
authors.affiliation: Unit for Social Epidemiology, Faculty of Medicine, Lund University, Malmö, Sweden.
authors.forename: Juan
authors.initials: J
authors.lastname: Merlo
authors.affiliation: Department of Logopedics, Phoniatrics and Audiology, Faculty of Medicine, Lund University, Lund, Sweden.
authors.forename: Viveka
authors.initials: V
authors.lastname: Lyberg-Åhlander
authors.affiliation: Department of Psychology, Faculty of Social Sciences, Lund University, Lund, Sweden.
authors.forename: Elia
authors.initials: E
authors.lastname: Psouni
mesh_terms: D000293:Adolescent; D000328:Adult; D002971:Cleft Lip / Q000453:epidemiology*; D002972:Cleft Palate / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011619:Psychotropic Drugs; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: EPIDEMIOLOGY; MENTAL HEALTH; ORAL & MAXILLOFACIAL SURGERY; PAEDIATRICS
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