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Introduction Non-pharmacological treatment like psychotherapy is associated with less side effects than pharmacological treatment and is often considered first-line treatment towards psychiatric disorders. The extent and variation of psychotherapy treatment offered in Danish psychiatric clinics over time has not previously been studied. Objectives To examine the nationwide use of psychotherapy treatment during 2001-2020 in individuals assigned with a psychiatric disorder diagnosis at Danish psychiatric clinics. Methods All Danish individuals aged ≥ 3 years, who were registered with 1) a psychiatric disorder diagnosis (F10-F99) or 2) had a first psychotherapy treatment during the study period 1 January 2001 to 31 December 2020, were identified in the Danish National Patient Registry. Results A total of 120,916 (27 %) study participants received psychotherapy treatment during the study period, most commonly individual psychotherapy (65 %) followed by group therapy (25 %). Adults (≥18 years) were more likely to receive therapy (34 %) than children and adolescents aged 3-17 years (15 %). The proportion of treated patients was highest among women (67 %) compared with men (33 %). The median age at first psychotherapy was 25 years (ranging from 19 to 33). 59 % of patients receiving psychotherapy had filled a psychotropic prescription within one year prior to therapy onset, particularly antidepressants (44 %) and antipsychotics (22 %). Conclusions The use of psychotherapy for treatment of psychiatric disorders is limited among Danish patients, although national clinical guidelines recommend it as first-line treatment of common conditions such as depressive, anxiety and obsessive-compulsive disorders. Disclosure No significant relationships.

Introduction To ensure rational drug use, there is a need to continuously monitor the use of ADHD medication among children and adolescents. Objectives To describe the use of ADHD medication among Danish children and adolescents from 2010-2020. Methods Using the Danish national healthcare registries, we extracted data on filled prescriptions of ADHD medication (including methylphenidate, atomoxetine, guanfacine, dexamphetamine, and lisdexamphetamine) among children (age 6-12 years) and adolescents (age 13-17 years) between 2010-2020. We examined the annual incidence rate and prevalence proportion of ADHD drug use, and the proportion of children and adolescents having an ADHD diagnosis when initiating ADHD medication. Results From 2010-2020, the incidence followed a u-shaped trend with an incidence rate of 4.9/1,000 children and 4.4/1,000 adolescents in 2010, decreasing to 3.2/1,000 children and 3.0/1,000 adolescents in 2013, and rising to 4.9/1,000 children and 4.8/1,000 adolescents in 2020. The prevalence for children showed a similar trend, shifting from 17/1,000 in 2010, to 15/1,000 in 2016, and peaking at 19/1,000 children in 2020. However, among adolescents the prevalence increased steadily from 19/1,000 in 2010 to 29/1,000 in 2020. 67% of children and 53% of adolescents initiating ADHD medication had an ADHD diagnosis. Conclusions After an initial decline in incidence rates of ADHD medication use among Danish children and adolescents, there has been a rise in use the last five years. The same trend applied for the prevalence among children, whereas the prevalence among adolescents increased steadily over the entire period. More than half of children and adolescents initiating ADHD medication were diagnosed with ADHD. Disclosure No significant relationships.

Introduction The Nordic countries have similar health care and welfare systems, and rather homogenous populations. Therefore, it is reasonable to expect similar use of psychotropic drugs. However, recent studies show marked differences in a range of psychotropic drug classes among children and adolescents in Sweden, Norway, and Denmark. Objectives To review the literature regarding psychotropic drug use among children and adolescents in the Nordic countries. Methods We performed a critical systematic literature review according to PRISMA guidelines and registered the study protocol at PROSPERO. Three scientific databases were used: PsycINFO, EMBASE and PubMed. Inclusion criteria were: 1) Age: 3-19 years, 2) Country: Denmark, including Faroe Islands and Greenland, Sweden, Norway, Finland, including Aland, and Iceland, 3) Drug of interest: Psychotropics, including Antidepressants, ADHD medication, antipsychotics, hypnotics, anxiolytics, 4) Population based study sample, 5) Observational study design, 6) Original data, 7) English language, 8) Publication date: 2010-2021. The review process was performed by four reviewers in three steps: 1) title/abstract screening, 2) full text screening, and 3) data extraction, including risk of bias assessment. Before study initiation, acceptable interrater reliability was ensured by pilot tests. Results The literature search was conducted October 6th, 2021. The PsycINFO database gave 285 hits, EMBASE 1190 hits and PubMed 2185 hits. In total, the literature search gave 3660 hits, of which 294 were duplicates, leaving us with 3366 references. The first screening phase is in process and results will be presented at the EPA conference. Conclusions The results of the systematic review will be interpreted and discussed. Disclosure No significant relationships.

Introduction Hypnotic drug use in children and adolescents is widely debated. Objectives To describe use of hypnotic drugs (melatonin, z-drugs and sedating antihistamines) among 5-24-year-old Scandinavians during 2012 to 2018. Methods Aggregate-level data from public data sources in Sweden, Norway and Denmark. We calculated annual prevalence (users/1000 inhabitants) stratified by sex, age group and country. Quantity of use (Defined Daily Dose (DDD)/user/day) was estimated for Norway and Denmark. Results Melatonin was most frequently used, with an increase from 2012 to 2018 in all countries. Sweden presented the highest rise (7 to 25/1,000) compared to Denmark (6 to 12/1,000) and Norway (10 to 20/1,000). The increase was strongest for females and 15-24-year-olds. Melatonin use was twice as common for males under age 15 years, and slightly more common for females thereafter. The annual prevalence of sedating antihistamine use doubled from 7 to 13/1,000 in Sweden, whereas it was more stable in Norway and Denmark, reaching 8/1,000 and 3/1,000, respectively. Z-drug use decreased in all countries, lowering to 4/1,000 in Sweden and Norway in 2018 and 2/1,000 in Denmark. The quantity of hypnotic use in Norway and Denmark was 1 DDD/user/day for melatonin, as compared to 0.1-0.3 for z-drugs and antihistamines. Conclusions There is an increasing use of melatonin and sedating antihistamines among Scandinavian children, adolescents and young adults. The increase is more pronounced in Sweden compared to Norway and Denmark. This Scandinavian discrepancy could reflect variation in frequency of sleep problems or national variation in clinical practice or health care access. Disclosure No significant relationships.