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Mental Distress and Psychotropic Drug Use among Young People, and Public Health Nurses` Conceptions of Their Roles
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis was to study mental distress, health and lifestyle habits, social factors and psychotropic drug use by young people, and how PHNs conceive their roles in relation to this.

Methods: Quantitative and qualitative methods were used. Study I included data  from the Norwegian Youth Health Study (NYHS, 11 620 participants, aged 15-16 years) (2000–2003) linked to the Norwegian Prescription Database (NorPD) (2004–2009). Study II included prescription data on psychotropic drugs among 15-16 year olds from the NorPD (2006–2010). Eight young people were interviewed and qualitative content analysis was used to analyse the data (III). Study IV included interviews with 20 Public Health Nurses (PHN), and was analysed using a phenomenographic approach.

Main results: Mental distress was reported among 15.5% of the adolescents non-users of psychotropic drugs, 75% of whom were girls. In both genders reporting mental distress, incident psychotropic use was higher one to nine years, up to 27.7% among girls, as compared with the rest of the participants. In addition, health, lifestyle habits and social factors were associated with incident use (I). Psychotropic drug use increased during 2006–2010, hypnotics and melatonin accounted for most of the increase. In total, 16.4% of all incident psychotropic drug users in 2007 were still having prescriptions dispensed in 2010 (II). Young people experience both beneficial and undesired effects from psychotropic drugs. Access to professional support and follow-up was experienced as insufficient. Life with family, friends, school and work was influenced by psychotropic drug use, and they were afraid of being lonely and stigmatized (III). The PHNs conceived their roles in relation to young people as; the discovering PHNs who became aware of psychotropic drug use in the health dialogues and chose either to act or not to act in relation to this. Those PHNs who took action continued to be the cooperating PHNs who cooperated with the young people, their families, schools, and others. If cooperation was established, the supporting PHNs teach and support the young people in relation to psychotropic drug use (IV).

Conclusions: Attention must be paid to poor mental health and increasing psychotropic drug use by young people. Advances in knowledge, treatment and follow-up are needed. The prevalence of mental distress among young people, with differences between the genders, as well as between socioeconomic groups, should have consequences for health promotion strategies. PHNs in Norway, working in health centres and schools, have responsibility and opportunity to identify and follow-up young people with mental health problems.

Abstract [en]

Baksidestext

International studies indicate an increase in mental distress and psychotropic drug use among young people. In this thesis mental distress is reported among 15.5 % of the young people. Of those reporting mental distress 75 % were girls. One quarter of the girls reporting mental distress at 15-16 years of age was incident users of psychotropic drugs one to nine years later. Psychotropic drug use, increase among young people, particularly hypnotic drugs. The young people experience beneficial and undesired effects of the psychotropic drugs. They miss out on professional availability and follow-up, and experience negative reactions related to their psychotropic drug use by their significant others. The public health nurse who discovers psychotropic drug use among young people chooses either to act or not to act in relation to this. Those who choose to act continue to cooperate with the young people and others. An established cooperation was followed by a public health nurse who supports and teaches the young people. The prevalence of mental distress, with a high frequency of initiation of psychotropic drug use among young people should have consequences for health promotion in the school health service. Public health nurses, working in health centers and schools, have a responsibility to promote health and prevent health problems. They have the responsibility and opportunity to identify young people struggling with mental health problems and psychotropic drug use as well as teach and support significant others.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2014. , 80 p.
Series
Karlstad University Studies, ISSN 1403-8099 ; 2014:2
Keyword [en]
Adolescents, young people, mental distress, mental health problems, psychotropic drug use, public health nurse
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-30600ISBN: 978-91-7063-531-1 (print)OAI: oai:DiVA.org:kau-30600DiVA: diva2:675611
Public defence
2014-01-24, Auditorie 1, Høgskolen i Hedmark, Hedmark, 10:30 (Norwegian)
Opponent
Supervisors
Available from: 2013-12-19 Created: 2013-12-04 Last updated: 2014-05-20Bibliographically approved
List of papers
1. Mental distress and subsequent use of psychotropic drugs among adolescents: a prospective register linkage study
Open this publication in new window or tab >>Mental distress and subsequent use of psychotropic drugs among adolescents: a prospective register linkage study
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2012 (English)In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972, Vol. 50, no 6, 578-587 p.Article in journal (Refereed) Published
Abstract [en]

Purpose

To investigate the association between mental distress, other factors, and subsequent use of psychotropic drugs in adolescents aged 15–16 years.

Methods

This study is based on information retrieved from the Norwegian Youth Health Surveys (2000–2003) and linked to prescription data from the Norwegian Prescription Database (2004–2009). The study population included 11,620 adolescents aged 15–16 (87% response rate) years. Self-reported mental distress (Hopkins Symptom Checklist-10 score 1.85) was recorded along with health and lifestyle habits, education plans, and family economics. Incident psychotropic drug use (outcome measure) was defined ≥1 prescriptions of one of the following psychotropic drugs: anxiolytics, hypnotics, antidepressants, or phenothiazines registered in the Norwegian Prescription Database.

Results

Overall, 15.5% of the adolescents reported mental distress, 75% of them were girls. For both genders, incident psychotropic use was significantly higher among those reporting mental distresses at baseline, compared with the rest of the participants. The highest psychotropic drug use was observed among mentally distressed girls (27.7%). Mental distress was significantly associated with incident use of psychotropic drugs (odds ratio: 2.25, 95% confidence interval: 1.97–2.55). After adjustment for confounding factors and inclusion of potential mediating factors, the odds ratio attenuated to 1.59 (95% confidence interval: 1.35–1.86).

Conclusions

The prevalence of mental distress among adolescents may have consequences for health promotion. Public health nurses in Norway, working in health centers and schools, have a responsibility to promote health and prevent health problems. They have the opportunity and a responsibility to identify vulnerable young people.

National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-12606 (URN)10.1016/j.jadohealth.2011.10.011 (DOI)000304668600008 ()
Available from: 2012-03-28 Created: 2012-03-28 Last updated: 2017-12-07Bibliographically approved
2. Increase in psychotropic drug use between 2006 and 2010 among adolescents in Norway: A nationwide prescription database study
Open this publication in new window or tab >>Increase in psychotropic drug use between 2006 and 2010 among adolescents in Norway: A nationwide prescription database study
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2012 (English)In: Clinical Epidemiology, ISSN 1179-1349, E-ISSN 1179-1349, Vol. 4, no 1, 225-231 p.Article in journal (Refereed) Published
Abstract [en]

Background: The purposes of this study were to investigate the prevalence of psychotropic (hypnotic, antidepressant, and anxiolytic) drug use among adolescents aged 15–16 years during the period 2006–2010 according to gender and subcategories of psychotropics, and to study psychotropic drug use over the period 2007–2010 among incident users in 2007.Methods: This was a one-year prevalence and follow-up study based on information retrieved from the nationwide Norwegian prescription database for the period 2006–2010. The study population consisted of adolescents aged 15–16 years who had filled at least one prescription for a psychotropic drug in the study period. The main outcome measures were filling of hypnotic, antidepressant, and/or anxiolytic drug prescriptions.Results: Overall use of psychotropic drugs increased from 13.9 to 21.5 per 1000 among boys and from 19.7 to 24.7 per 1000 among girls during the 2006–2010 period. Hypnotic drugs, and melatonin in particular, accounted for most of the increase. For melatonin, the annual median amount dispensed was 180 defined daily doses through the period until 2010, at which time it decreased to 90 defined daily doses. In total, 16.4% of all incident psychotropic drug users in 2007 were still having prescriptions dispensed in 2010.Conclusion: This study shows an increase in hypnotic drugs dispensed for adolescents in Norway, mainly attributable to the increasing use of melatonin. The amount of melatonin dispensed indicates more than sporadic use over longer periods, despite melatonin only being licensed in Norway for use in insomnia for individuals aged 55 years or older.

Place, publisher, year, edition, pages
Dove Medical Press, 2012
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-15799 (URN)10.2147/CLEP.S31624 (DOI)
Available from: 2012-11-27 Created: 2012-11-27 Last updated: 2017-12-07Bibliographically approved
3. Experience of psychotropic drug use among young people with mental health problems
Open this publication in new window or tab >>Experience of psychotropic drug use among young people with mental health problems
2015 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, no 4, 241-248 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the study is to describe the experience of psychotropic drug use among young people with mental health problems. Young people experience mental health problems, and some will need to take psychotropic drugs for either a short or a long time. Psychotropic drugs may be effective in reducing mental distress, but raise questions about increasing use, side effects, long-term treatment and off-label use. Qualitative interviews were accomplished with eight young people who had taken psychotropic drugs. Three categories were identified: ‘Effects of psychotropic drugs’, ‘Access of professional care and follow-up’ and ‘Social life and psychotropic drug use’. The young people experienced both beneficial and undesired effects from the psychotropic drugs. They experienced lack of access to professional support and follow-up. Life with family and friends was influenced negatively by psychotropic drug use and the young people were afraid of being lonely and stigmatized. The results may have implications for those who work with young people. Young people striving with mental health problems and psychotropic drug use have to have access to professional support and follow-up. Knowledge about effects of psychotropic drug use among young people is needed. The work about openness about mental health problems among young people has to continue.

Place, publisher, year, edition, pages
Sage Publications, 2015
Keyword
mental health problems, Psychotropic drug use, adolescence
National Category
Medical and Health Sciences Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-30761 (URN)10.1177/0107408315592805 (DOI)
Available from: 2013-12-19 Created: 2013-12-19 Last updated: 2017-09-19Bibliographically approved
4. Manuscript Public health nurses´ conception of their roles in relation to psychotropic drug use among adolescents.
Open this publication in new window or tab >>Manuscript Public health nurses´ conception of their roles in relation to psychotropic drug use among adolescents.
(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-30762 (URN)
Available from: 2013-12-19 Created: 2013-12-19 Last updated: 2014-11-20Bibliographically approved

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