Publicatie datum

Psychotropic medication use among adolescent disaster survivors: a prospective cohort study.

Dorn, T., Yzermans, C.J., Kerssens, J.J., Veen, P.M.H. ten. Psychotropic medication use among adolescent disaster survivors: a prospective cohort study. European Journal of Public Health: 2004, 14(4 Suppl.) 70. Abstract. 12 th Annual EUPHA meeting: Urbanisation and health: new challenges in health promotion and prevention in Oslo, Norway, 7-9 october 2004.
Background: We study the health consequences of a fire disaster which took place on January 1st, 2001, in Volendam, the Netherlands. The fire occurred in a discotheque where about 300 youngsters were celebrating new year’ eve. 14 youngsters were killed and about 200 injured. Next to the threat,to their own life and body, the youngsters also witnessed the death or injury of friends and peers. Aim: We aim at answering the following questions: 1) Is there a post-disaster increase of psychotropic medication use in the surviving youngsters? 2) If yes, how long do the effects persist? 3) Do severity of injury, age, gender and insurance status predict medication use? Methods: This prospective cohort study covers one year pre-disaster and three years post-disaster. Other youngsters from the same community (n=2988) serve as controls for the survivors (n=324). Data are extracted from pharmacy records. Results: 1) Number of prescriptions dispensed: Immediately after the fire, we observe a sharp increase in psychotropic medications dispensed for the surviving youngsters. Rates stay at an elevated level during the first year post-disaster and then start to normalize in the course of the second year. 2) Number of new users: 39,2% of the surviving youngsters receive at least one psychotropic prescription for the first time in the year post-disaster (controls: 6,6%). 24,1% of the survivors are new users of benzodiazepines (controls: 2,9%). Antidepressant prescriptions are less prevalent: here, the rate of new users is 7,1%
(controls: 0,7%). At the conference, we will also present the a risk factor model considering severity of burn injury, age, gender and insurance status. Conclusions: Pharmacy records form an important indicator for the health status of the surviving youngsters. From a caregiver point of view, the study helps to identify those at risk for the development of mental health problems. In addition, it enables policy makers to anticipate the impact of future comparable events.