Patel Nick C, Crismon M Lynn, Shafer Alan
Department of Pharmacy Practice, College of Pharmacy, University of Cincinnati, Cincinnati, OH 45267-004, USA.
Ann Pharmacother. 2006 Feb;40(2):205-11. doi: 10.1345/aph.1G203. Epub 2006 Jan 24.
The use of antipsychotics, namely newer atypical agents, has increased significantly in children and adolescents. It is important to examine diagnoses associated with antipsychotic treatment in youths.
To evaluate trends in psychiatric diagnoses of children and adolescents in a public mental health system who were prescribed antipsychotics.
Children and adolescents, up to the age of 19 years, who were prescribed an antipsychotic between January 1998 and December 2001 were identified using the Texas Medicaid Vendor Drug database. Patient identification numbers were then cross-linked to the Client Assignment and Registration database of the Texas Department of Mental Health and Mental Retardation to extract diagnostic data.
Disruptive behavioral disorders accounted for the highest percentage (35%) of diagnoses associated with children and adolescents receiving antipsychotic treatment and mental healthcare services. Depressive disorders were the second most common diagnosis (18%), and bipolar disorders accounted for roughly 12% of all diagnoses. Approximately 3% of children and adolescents did not have a psychiatric diagnosis. The percentage of youths with comorbid psychiatric diagnoses decreased over time.
Although disruptive behavioral disorders accounted for a large percentage of antipsychotic use in this population, these findings suggest that antipsychotics are being used to treat other psychiatric diagnoses, for which limited supporting data exist. Future research in children and adolescents should aim to provide needed efficacy and safety data of antipsychotics across the spectrum of neuropsychiatric disorders.
抗精神病药物，尤其是新型非典型抗精神病药物，在儿童和青少年中的使用显著增加。研究与青少年抗精神病药物治疗相关的诊断情况很重要。
评估在公共心理健康系统中接受抗精神病药物治疗的儿童和青少年的精神科诊断趋势。
利用德克萨斯医疗补助供应商药物数据库，确定1998年1月至2001年12月期间接受抗精神病药物治疗的19岁及以下儿童和青少年。然后将患者识别号与德克萨斯精神健康和智力障碍部的客户分配与登记数据库进行交叉链接，以提取诊断数据。
破坏性行为障碍在接受抗精神病药物治疗和精神卫生保健服务的儿童和青少年相关诊断中占比最高（35%）。抑郁症是第二常见的诊断（18%），双相情感障碍约占所有诊断的12%。约3%的儿童和青少年没有精神科诊断。患有合并精神科诊断的青少年比例随时间下降。
虽然破坏性行为障碍在该人群中抗精神病药物使用中占很大比例，但这些发现表明抗精神病药物正被用于治疗其他精神科诊断，而对此存在的支持数据有限。未来关于儿童和青少年的研究应旨在提供抗精神病药物在各种神经精神疾病中的疗效和安全性所需数据。
