精神药物对儿童的不良反应：预测因素
Adverse effects of psychotropic medications in children: predictive factors.
作者信息
Ninan Ajit, Stewart Shannon L, Theall Laura A, Katuwapitiya Shehan, Kam Chester
机构信息
Child and Parent Resource Institute, London, Ontario ; Western University, London, Ontario.
Western University, London, Ontario ; Child and Parent Resource Institute, London, Ontario.
出版信息
J Can Acad Child Adolesc Psychiatry. 2014 Sep;23(3):218-25.
OBJECTIVE
Despite limited information related to efficacy in children, psychotropic medications are commonly prescribed as a first-line treatment for a range of psychiatric diagnoses in children in a variety of clinical settings. Usage has increased over the past three decades. Although psychotropic medications are often effective at treating psychiatric symptoms, the risk of adverse effects (AE) in children is unclear. The current research seeks to identify the mental health characteristics of those children at highest risk of experiencing potential AE from psychotropic medications.
METHODS
Psychotropic medication monitoring checklists were used to record possible AE for 99 pediatric clients in a tertiary mental health residential treatment centre for the duration of one to eight weeks. Client characteristics, including the number of diagnoses and behavioural variables, were explored for predictive value of potential AE observed.
RESULTS
Results showed that the total number of potential AE was positively predicted by the number of DSM-IV categories diagnosed, as well as behavioural symptoms of impulsiveness and uncooperativeness.
CONCLUSIONS
The findings of this study indicate that the number of potential AE from psychotropic medications may be predictable based on client characteristics. Predicting this likelihood during initial assessment can be useful in directing and monitoring treatment, as well as preventing serious events related to medication use.
目的
尽管关于儿童用药疗效的信息有限，但在各种临床环境中，精神药物通常被作为儿童一系列精神疾病诊断的一线治疗药物。在过去三十年中，其使用量有所增加。虽然精神药物通常对治疗精神症状有效，但儿童出现不良反应（AE）的风险尚不清楚。当前的研究旨在确定那些因精神药物而面临潜在AE风险最高的儿童的心理健康特征。
方法
在一家三级心理健康住院治疗中心，使用精神药物监测清单记录了99名儿科患者在一至八周内可能出现的AE。探讨了包括诊断数量和行为变量在内的患者特征对观察到的潜在AE的预测价值。
结果
结果显示，潜在AE的总数可由诊断出的DSM-IV类别数量以及冲动和不合作的行为症状正向预测。
结论
本研究结果表明，基于患者特征，精神药物潜在AE的数量可能是可预测的。在初始评估期间预测这种可能性有助于指导和监测治疗，以及预防与药物使用相关的严重事件。
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