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Objectives: The Major Depression Inventory (MDI) was constructed to assess DSM‐IV and ICD‐10 depression symptoms, and does not fully cover the symptoms listed in DSM‐5 and ICD‐11. This study aimed to augment the MDI to the new diagnostic standards by adding a new item, and to assess and compare the measurement performance of the MDI items and diagnostic algorithms for major depression according to DSM‐IV, ICD‐10, DSM‐5 and ICD‐11. Methods: Surveys collected 2001–2003 and 2021, including self‐assessed MDI were used. A new hopelessness item was constructed and analyzed alongside the hopelessness item in the Symptom Checklist. The performance of items was compared using Rasch and Mokken analyses. Criterion validity was examined using equivalent diagnoses from psychiatric interview (Schedules for Clinical Assessments in Neuropsychiatry [SCAN]) as standard. Results: MDI information was provided by 8511 individuals in 2001–2003 (SCAN subsample n = 878), and 8863 in 2021. All items, including hopelessness had good psychometric properties. Sensitivity ranged between 56% and 70%, and specificity between 95% and 96%, indicating similar criterion validity. Conclusions: Hopelessness and the MDI items had good psychometrics. MDI for DSM‐5 and ICD‐11 had similar validity as for DSM‐IV and ICD‐10. We recommend that MDI is updated to DSM‐5 and ICD‐11 by adding a hopelessness item. [ABSTRACT FROM AUTHOR]

Aim: Psychotropic drugs like opioids and benzodiazepines are prescribed for traumas resulting from road traffic crashes and the risk of developing an addiction deserves consideration. This study aims to shed light on how the consumption of those drugs evolves over time among older road traffic injury (RTI) victims. Methods: We conducted a nationwide Swedish register‐based longitudinal study to identify trajectories of post‐RTI psychotropic drug use. All individuals aged 50 years and older who had a hospital visit for an RTI from 2007 to 2015 were followed up during a 2‐year period; those who used the drugs prior to the RTI were excluded. Trajectories were identified by performing latent class trajectory analysis on drug dispensation data for opioids and benzodiazepines separately (66 034 and 66 859 adults, respectively, in total). Results: Three trajectories were identified for opioids and four for benzodiazepines. The largest group in both instances included people with no‐use/minimal use throughout the follow‐up (81.3% and 92.8%). "Sporadic users" were more frequent among users of opioids (16.7%) than benzodiazepines (4.3%), whereas "chronic users" were found in similar proportions (2.0% and 1.8%). "Delayed chronic use" characterized the fourth group of benzodiazepine users (1.0%). Conclusion: Several trajectories of psychotropic drug use were identified after RTI, from limited to chronic. Although chronic use was uncommon, a better understanding of the factors likely to increase that risk is warranted given the seriousness of the problem. [ABSTRACT FROM AUTHOR]

It has been shown that newly initiated opioid therapy increases the risk of fall-related injuries. Yet, it remains to be determined whether drug-drug interactions can affect this negative effect, for instance with drugs inhibiting cytochrome P4502 D6 ( CYP2 D6) that metabolizes codeine and also has a partial effect on tramadol and oxycodone. Our aim was to investigate how CYP2 D6-inhibiting drugs contribute to explaining the risk of fall-related injuries for newly initiated opioid treatments with codeine, tramadol or oxycodone. Data from a Swedish national case-cross over study were revisited. This study identified a total of 167,257 fall-related injuries leading to hospitalization that occurred between 1 May 2006 and 31 December 2009 and linked information about dispensed drugs to them. Use of newly dispensed opioids in the 28 days before fall-related injury with and without CYP2 D6-inhibiting drugs was compared with an earlier control period. For codeine, there was a two-times increased risk with concomitant CYP2 D6-inhibiting drug use ( OR, 1.76; 95% CI 1.40-2.20) and a three-times risk increase without ( OR, 3.17; 95% CI 2.88-3.50). For tramadol, the risks were doubled when CYP2 D6-inhibiting drugs were used ( OR, 2.19; 95% CI 1.84-2.60) and tripled without their use ( OR, 3.04; 95% CI 2.82-3.27). The risks were about the same for oxycodone, morphine, fentanyl and buprenorphine irrespective of CYP2 D6-inhibiting drug use. In newly initiated opioid therapies, drug-drug interactions from concomitant use of CYP2 D6-inhibiting drugs are associated with a lower risk of fall-related injury for codeine and tramadol that undergo metabolism via CYP2 D6, but not for other opioids. [ABSTRACT FROM AUTHOR]