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受照料儿童中精神药物的使用情况:兰贝斯区的一项审计

Use of psychotropics among looked after children: an audit in the Borough of Lambeth.

作者信息

Pinto Carmen, Barrett Nadia

机构信息

Consultant Child and Adolescent Psychiatrist.

Locum Consultant Child and Adolescent Psychiatrist South London and Maudsley NHS Foundation Trust, London, UK.

出版信息

London J Prim Care (Abingdon). 2010 Jul;3(1):52-7. doi: 10.1080/17571472.2010.11493297.

Abstract

Background Looked after children and young people (LAC) have higher incidence of mental health problems than non-looked after children. Many mental health difficulties are missed in this group, in particular the effects of trauma and loss and the resulting depression. LAC often move between placements, which further disrupts their care and therapeutic interventions. NICE recommends that in most mental health disorders, children and adolescents should receive specific psychological therapies as first-line treatment, before medication. This standard should apply to LAC. Setting The audit was conducted in the Lambeth CLAMHS, a specialist mental health team working with LAC. Question To ascertain if Lambeth LAC (living in the borough) are receiving psychotropic medication without CLAMHS input and as their only treatment. (All LAC who are on psychotropic medication should have been offered psychological treatments first.) Methods A questionnaire was sent out to Lambeth general practice (GP) surgeries to find out what medications children were prescribed, if any. When children were prescribed psychotropic medication checks were made to ascertain whether they were receiving input from mental health services. Results LAC were seen in 67 different GP surgeries across Lambeth. Responses from 63 surgeries relating to 145 children (87.34% of the total number) were received. Conclusions There were no LAC in Lambeth who were prescribed psychotropic medication without a CAMHS service being involved. All the patients that were on psychotropic medication were known by CLAMHS or another child and adolescent mental health service within the South London and Maudsley NHS Foundation Trust. This is in accordance with NICE recommendations.

摘要

背景

受照料儿童和青少年(LAC)出现心理健康问题的发生率高于非受照料儿童。该群体中许多心理健康问题未被发现,尤其是创伤和丧失的影响以及由此导致的抑郁。LAC经常在不同安置机构间辗转,这进一步扰乱了他们的照料和治疗干预。英国国家卫生与临床优化研究所(NICE)建议,在大多数心理健康障碍中,儿童和青少年应在用药前接受特定心理治疗作为一线治疗。这一标准应适用于LAC。

设置

此次审计在兰贝斯儿童与青少年心理健康服务(CLAMHS)开展,这是一个专门为LAC提供服务的心理健康团队。

问题

确定居住在兰贝斯区的LAC是否在未经过CLAMHS介入且仅接受药物治疗的情况下就被开具了精神类药物。(所有正在服用精神类药物的LAC都应首先接受心理治疗。)

方法

向兰贝斯区的全科医生(GP)诊所发放问卷,以了解给儿童开具了哪些药物(如有)。当儿童被开具精神类药物时,进行检查以确定他们是否接受了心理健康服务的介入。

结果

在兰贝斯区的67家不同的GP诊所中发现了LAC。收到了来自63家诊所关于145名儿童(占总数的87.34%)的回复。

结论

在兰贝斯区,没有LAC在未涉及儿童与青少年心理健康服务(CAMHS)的情况下被开具精神类药物。所有正在服用精神类药物的患者都为CLAMHS或南伦敦和莫兹利国民保健服务基金会信托基金内的其他儿童和青少年心理健康服务机构所知。这符合NICE的建议。

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本文引用的文献

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Psychotropic medication use in a national probability sample of children in the child welfare system.
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