title: Mental health service use, depression, panic disorder and life events among Swedish young adults in 2000 and 2010: a repeated cross-sectional population study in Stockholm County, Sweden.
abstract: The use of specialised psychiatric services for depression and anxiety has increased steadily among young people in Sweden during recent years. It is not known to what extent this service use is due to an increase in psychiatric morbidity, or whether other adversities explain these trends. The aim of this study is to examine if there is increased use of psychiatric services among young adults in Sweden between 2000 and 2010, and if so, to what extent this increase is associated with differences in depression, anxiety and negative life events.
  
  
  
  This is a repeated cross-sectional study of 20-30-year old men and women in Stockholm County in 2000 and 2010 (n = 2590 and n = 1120). Log-binomial regression analyses were conducted to compare the prevalence of service use, depression and panic disorder between the two cohorts. Self-reported life events were entered individually and as a summary index, and entered as potential mediators. Different effects of life events on service use were examined through interaction analysis. We report prevalence proportion ratios (PPR) with 95% confidence intervals.
  
  
  
  Specialised psychiatric service use, but also depression and panic disorder was more common in the younger cohort (current service use 2.4 and 5.0%). The younger cohort did not report more life events overall or among those with depression or anxiety. Neither depression, panic disorder nor life events could explain the increased use of psychiatric services in the younger cohort (Fully adjusted model PPR = 1.70, 1.20-2.40 95% CI). There was no significant interaction between cohort and life events in predicting psychiatric service use.
  
  
  
  This study provides initial support for an increase in service use among young adults compared with 10 years earlier. The increased service use cannot be explained with increasing worse life situations.
authors.affiliation: Department of Public Health Sciences,Karolinska Institutet,Stockholm,Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Lundin
authors.affiliation: Department of Public Health Sciences,Karolinska Institutet,Stockholm,Sweden.
authors.forename: Y
authors.initials: Y
authors.lastname: Forsell
authors.affiliation: Department of Public Health Sciences,Karolinska Institutet,Stockholm,Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Dalman
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008605:Mental Health Services / Q000706:statistics & numerical data*; D016584:Panic Disorder / Q000453:epidemiology*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Anxiety; cohort effect; depression; hospitals psychiatric; life change events