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澳大利亚患有注意力缺陷/多动障碍和重度抑郁症的儿童及青少年使用兴奋剂和抗抑郁药的情况:一项全国性调查。

The Prevalence of Stimulant and Antidepressant Use by Australian Children and Adolescents with Attention-Deficit/Hyperactivity Disorder and Major Depressive Disorder: A National Survey.

作者信息

Sawyer Michael G, Reece Christy E, Sawyer Alyssa C P, Johnson Sarah, Lawrence David, Zubrick Stephen R

机构信息

1 School of Medicine, University of Adelaide , Adelaide, South Australia, Australia .

2 Research and Evaluation Unit, Women's and Children's Health Network , Adelaide, South Australia, Australia .

出版信息

J Child Adolesc Psychopharmacol. 2017 Mar;27(2):177-184. doi: 10.1089/cap.2016.0017. Epub 2016 May 6.

DOI:10.1089/cap.2016.0017
PMID:27154239
Abstract

OBJECTIVES

To identify the prevalence of stimulant and antidepressant medication use by children and adolescents with symptoms meeting the criteria for attention-deficit/hyperactivity disorder (ADHD) and major depressive disorder (MDD) in Australia. To identify factors associated with stimulant and antidepressant use by children and adolescents in Australia.

METHODS

Data are from a nationally representative sample of 4- to 17-year-olds (n = 6310). Parents completed the Diagnostic Interview Schedule for Children-Version IV (DISC-IV) and the Strengths and Difficulties Questionnaire. Eleven- to 17-year-olds completed a self-report version of the DISC-IV MDD module. Interviewers recorded prescribed medications used by participants in the previous 2 weeks.

RESULTS

During a 2-week period, 1.3% of all 4- to 17-year-olds and 13.7% of those with symptoms meeting the criteria for ADHD had used stimulant medication, while 0.9% of all 4- to 17-year-olds and 13.4% with MDD had used antidepressants. In total, 22.6% of those using stimulant medications and 57.7% using antidepressant medications did not have symptoms meeting criteria for ADHD or MDD, respectively. Among 11- to 17-year-olds, 5.6% of those with adolescent-only-reported MDD, 10.9% of those with parent/carer-only-reported MDD, and 25.7% of those with MDD reported by both parents/carers and adolescents were using antidepressant medications.

CONCLUSIONS

Only a minority of 4- to 17-year-olds with ADHD and MDD were being treated with stimulant or antidepressant medication. The percentage of adolescents with MDD using antidepressant medications varied depending on whether adolescents, parents/carers, or both identified the presence of MDD. This highlights the importance of using information from both these informants when assessing and treating adolescent depressive disorder.

摘要

目的

确定在澳大利亚,有符合注意力缺陷多动障碍(ADHD)和重度抑郁症(MDD)标准症状的儿童和青少年使用兴奋剂和抗抑郁药物的情况。确定澳大利亚儿童和青少年使用兴奋剂和抗抑郁药物的相关因素。

方法

数据来自4至17岁具有全国代表性的样本(n = 6310)。父母完成了儿童诊断访谈量表第四版(DISC-IV)和优势与困难问卷。11至17岁的青少年完成了DISC-IV中MDD模块的自我报告版本。访谈者记录了参与者在过去2周内使用的处方药。

结果

在为期2周的时间里,所有4至17岁儿童中有1.3%以及有符合ADHD标准症状的儿童中有13.7%使用了兴奋剂药物,而所有4至17岁儿童中有0.9%以及有MDD的儿童中有13.4%使用了抗抑郁药物。总体而言,使用兴奋剂药物的儿童中分别有22.6%、使用抗抑郁药物的儿童中有57.7%没有符合ADHD或MDD的标准症状。在11至17岁的青少年中,仅青少年报告患有MDD的患者中有5.6%、仅父母/照顾者报告患有MDD的患者中有10.9%,以及父母/照顾者和青少年均报告患有MDD的患者中有25.7%正在使用抗抑郁药物。

结论

患有ADHD和MDD的4至17岁儿童中只有少数正在接受兴奋剂或抗抑郁药物治疗。患有MDD的青少年使用抗抑郁药物的比例因青少年、父母/照顾者或双方是否认定存在MDD而异。这凸显了在评估和治疗青少年抑郁症时使用这两种信息提供者信息的重要性。

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