TY - JOUR
T1 - Mood and neurotic disorders among youth with prenatal substance exposure
T2 - A longitudinal register-based cohort study
AU - Nissinen, Niina Maria
AU - Sarkola, Taisto
AU - Autti-Rämö, Ilona
AU - Gissler, Mika
AU - Kahila, Hanna
AU - Koponen, Anne M.
N1 - Funding Information:
The work was supported by Samfundet Folkhälsan i svenska Finland rf; the Juho Vainio foundation; the Signe and Ane Gyllenberg Foundation; Medicinska Understödsföreningen Liv och Hälsa rf.; the Alli Paasikivi Foundation. The funding sources had no role in this study.
Publisher Copyright:
© 2022 The Authors
PY - 2022/7
Y1 - 2022/7
N2 - Background: Prenatal substance exposure is associated with mood and neurotic disorders but this association is complex and understudied. This study investigated the recorded use of specialised healthcare services for mood and neurotic disorders among youth with prenatal substance exposure in comparison with an unexposed matched cohort. Furthermore, the influence of adverse maternal characteristics and out-of-home care (OHC) is investigated. Methods: This longitudinal register-based matched cohort study included 594 exposed and 1735 unexposed youth. Cox proportional hazard regression models were applied to study the first episode of mood and neurotic disorders in specialised healthcare from 13 years of age, and the influence of adverse maternal characteristics and OHC. Mediation analysis was applied to study the mediating effect of OHC on the association between prenatal substance exposure and the disorders. Results: The exposed cohort had a two-fold higher likelihood of being treated at specialised healthcare for mood and neurotic disorders compared with the unexposed cohort (HR 2.34, 95% CI 1.86–2.95), but this difference was attenuated to non-significant levels (AHR 1.29, 95% CI 0.92–1.81) following adjustments with adverse maternal characteristics and OHC. OHC mediated 61% (95% CI 0.41–0.94) of the association between prenatal substance exposure and youth's mood and neurotic disorders. Limitations: Register data likely include more severe cases of disorders, and as an observational study, causality cannot be assessed. Conclusion: Mood and neurotic disorders are more common following prenatal exposure to substances and interlinked with significant adversities in the postnatal caregiving environment and OHC.
AB - Background: Prenatal substance exposure is associated with mood and neurotic disorders but this association is complex and understudied. This study investigated the recorded use of specialised healthcare services for mood and neurotic disorders among youth with prenatal substance exposure in comparison with an unexposed matched cohort. Furthermore, the influence of adverse maternal characteristics and out-of-home care (OHC) is investigated. Methods: This longitudinal register-based matched cohort study included 594 exposed and 1735 unexposed youth. Cox proportional hazard regression models were applied to study the first episode of mood and neurotic disorders in specialised healthcare from 13 years of age, and the influence of adverse maternal characteristics and OHC. Mediation analysis was applied to study the mediating effect of OHC on the association between prenatal substance exposure and the disorders. Results: The exposed cohort had a two-fold higher likelihood of being treated at specialised healthcare for mood and neurotic disorders compared with the unexposed cohort (HR 2.34, 95% CI 1.86–2.95), but this difference was attenuated to non-significant levels (AHR 1.29, 95% CI 0.92–1.81) following adjustments with adverse maternal characteristics and OHC. OHC mediated 61% (95% CI 0.41–0.94) of the association between prenatal substance exposure and youth's mood and neurotic disorders. Limitations: Register data likely include more severe cases of disorders, and as an observational study, causality cannot be assessed. Conclusion: Mood and neurotic disorders are more common following prenatal exposure to substances and interlinked with significant adversities in the postnatal caregiving environment and OHC.
KW - Childhood adversities
KW - FASD
KW - Mood disorders
KW - Neurotic disorders
KW - Prenatal substance exposure
U2 - 10.1016/j.jad.2022.04.039
DO - 10.1016/j.jad.2022.04.039
M3 - Article
C2 - 35439464
AN - SCOPUS:85128907606
SN - 0165-0327
VL - 308
SP - 328
EP - 336
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -
