Lakhan Shaheen E, Hagger-Johnson Gareth E
Global Neuroscience Initiative Foundation, Los Angeles, CA, USA.
Clin Pract Epidemiol Ment Health. 2007 Oct 20;3:21. doi: 10.1186/1745-0179-3-21.
Many psychotropics prescribed to children are unlicensed or off-label. This article uses the two most prescribed psychotropics (MPH and SSRIs) to illustrate various concerns about their impact on youth. Many mental illnesses begin in childhood or early adulthood, warranting a treatment of some kind. However, commentators have argued that prescribing is influenced by five myths: (1) children are little adults; (2) children have no reason to develop depression or anxiety; (3) psychiatric disorders are the same across adults and children; (3) children can be prescribed lower doses of the same drug; (5) drugs are preferable to alternative treatments and are more successful. Several lines of evidence suggest that these are incorrect assumptions. We update readers with recent research in relation to these myths, concluding that researchers should clarify child/adult differences for psychotropics, attend to the growth of "cosmetic" use of psychotropics in children and adolescents, and address concerns about the diagnostic validity of mental illness in the current DSM classification system.
许多开给儿童的精神药物是未获许可的或标签外使用的。本文使用两种最常开具的精神药物(哌甲酯和选择性5-羟色胺再摄取抑制剂)来说明对它们对青少年影响的各种担忧。许多精神疾病始于童年或成年早期,需要某种治疗。然而,评论者认为,开药受到五个误区的影响:(1)儿童是小大人;(2)儿童没有理由患上抑郁症或焦虑症;(3)成人和儿童的精神疾病是一样的;(4)儿童可以开较低剂量的同一种药物;(5)药物比替代治疗更可取且更有效。几条证据表明这些是错误的假设。我们向读者介绍与这些误区相关的最新研究,得出结论:研究人员应阐明精神药物在儿童/成人之间的差异,关注儿童和青少年中精神药物“美容性”使用的增长情况,并解决对当前《精神疾病诊断与统计手册》分类系统中精神疾病诊断有效性的担忧。