Antidepressant and antipsychotic prescriptions among 21 605 English survivors of childhood cancer: a population-based cohort
Menée à partir de données portant sur 21 605 patients anglais ayant survécu à un cancer pédiatrique diagnostiqué sur la période 1971-2006 (âge au diagnostic : 0-14 ans), cette étude de cohorte analyse les prescriptions d'antidépresseurs et d'antipsychotiques
Background: Mental health is an important aspect of wellbeing among childhood cancer survivors. Examining antidepressants and antipsychotics prescription patterns could provide insights into mental health needs, but comprehensive data on community prescribing remains limited. We investigated rates of antidepressant and antipsychotic prescriptions among childhood cancer survivors.
Methods: Using English national prescription data (April 2015-December 2021), we investigated antidepressant and antipsychotic prescription patterns in a population-based cohort of 21,605 five-year survivors of childhood cancer (diagnosed ages 0-14 years, 1971-2006). Prescription rates were compared with the general population using standardised incidence ratios (SIRs) and absolute excess risks (AERs), per 100 person-years.
Results: 31% of survivors received at least one antidepressant prescription (expected 21%) with prescription rates 50% greater than the general population (SIR=1.5, 95%CI: 1.5-1.5). Annually, 6% were prescribed antidepressants versus 4% expected, i.e. 2% in excess (AER=2.0, 95%CI: 1.8-2.1).
Female survivors had higher prescription rates than males (38.8% versus 24.2%; AER=2.7% versus 1.4%). Bone cancer survivors had the greatest antidepressant prescribing (SIR=2.0, 95%C 1.8-2.3), with 42% receiving prescriptions. Overall, 24% of survivors received SSRIs and 10% tricyclics. CNS tumour survivors had the highest antipsychotic prescription rate (SIR=2.4, 95%CI: 2.1-2.7).
Conclusion: This largest-to-date study shows higher antidepressant prescribing among childhood cancer survivors than previously recognised, particularly among women. Rather than indicating overtreatment, this likely reflects engagement with primary care and recognition of survivors' mental health needs. These findings highlight the importance of comprehensive mental health assessment during long-term follow-up and clear pathways for specialist mental health referral, as advocated by survivorship care guidelines.
Journal of the National Cancer Institute , résumé, 2026