Department of Psychiatry, University of Pittsburgh, USA.
Psychiatr Serv. 2012 Apr;63(4):351-6. doi: 10.1176/appi.ps.201100329.
The use of antipsychotic medications among children and adolescents has increased substantially in recent years, predominantly in disorders for which effective psychosocial interventions exist. The authors of this study examined the extent to which youths being prescribed antipsychotic medications were receiving concurrent mental health therapy.
Using administrative data, the authors identified 6,110 Medicaid-enrolled youths starting antipsychotic medications from November 1, 2006, through October 31, 2009, and identified youths who had received any concurrent mental health therapy. Multivariate regression models were used to examine the relationship between concurrent therapy and sociodemographic and clinical variables.
Sixty-eight percent (N=4,155) of youths starting antipsychotic medications received concurrent therapy. Multivariate regression findings are that concurrent therapy was more common with younger children, recently hospitalized youths, children from urban communities, youths from racial-ethnic minority groups, children with an antipsychotic-indicated diagnosis, and youths eligible for Medicaid because of family income.
The finding that 68% of youths starting antipsychotic medications received concurrent therapy suggests that for a majority of children, these medications complemented rather than substituted for nonpharmacologic interventions. However, with almost one-third of youths not receiving concurrent therapy, a better understanding of the factors contributing to the lack of concurrent therapy for youths starting antipsychotic medications is needed. Children and families should be aware of and have access to effective psychosocial treatments for disorders such as attention-deficit hyperactivity disorder and depression that are common among children receiving antipsychotic medications.
近年来，儿童和青少年使用抗精神病药物的情况大幅增加，主要是在存在有效心理社会干预的疾病中。本研究的作者检查了开处抗精神病药物的青少年同时接受心理健康治疗的程度。
作者使用行政数据，确定了 2006 年 11 月 1 日至 2009 年 10 月 31 日期间开始服用抗精神病药物的 6110 名医疗补助计划（Medicaid）参保青少年，并确定了接受任何同时进行的心理健康治疗的青少年。多变量回归模型用于检查同时治疗与社会人口统计学和临床变量之间的关系。
68%（N=4155）开始服用抗精神病药物的青少年接受了同时治疗。多变量回归结果表明，同时治疗在年龄较小的儿童、最近住院的青少年、来自城市社区的儿童、来自种族少数民族的儿童、患有抗精神病药物指征诊断的儿童和因家庭收入而有资格获得医疗补助的儿童中更为常见。
发现 68%开始服用抗精神病药物的青少年接受了同时治疗，这表明对于大多数儿童来说，这些药物补充了而非替代了非药物干预。然而，近三分之一的青少年没有接受同时治疗，因此需要更好地了解导致开始服用抗精神病药物的青少年缺乏同时治疗的因素。儿童和家庭应该了解并能够获得有效的心理社会治疗，例如注意力缺陷多动障碍和抑郁症，这些疾病在接受抗精神病药物治疗的儿童中很常见。
