Nydalen DPS, Department of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4950, Nydalen, N-0424 Oslo, Norway.
Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.O. Box 104, N-2381 Brumunddal, Norway.
Eur Psychiatry. 2018 Mar;49:16-22. doi: 10.1016/j.eurpsy.2017.12.009. Epub 2018 Feb 3.
Antipsychotic drug use among children and adolescents is increasing, and there is growing concern about off-label use and adverse effects. The present study aims to investigate the incidence, psychiatric co-morbidity and pharmacological treatment of severe mental disorder in Norwegian children and adolescents.
We obtained data on mental disorders from the Norwegian Patient Registry on 0-18 year olds who during 2009-2011 were diagnosed for the first time with schizophrenia-like disorder (International Classification of Diseases, 10th revision codes F20-F29), bipolar disorder (F30-F31), or severe depressive episode with psychotic symptoms (F32.3 or F33.3). Data on filled prescriptions for psychotropic drugs were obtained from the Norwegian Prescription Database.
A total of 884 children and adolescents (25.1 per 100 000 person years) were first time diagnosed with schizophrenia-like disorder (12.6 per 100 000 person years), bipolar disorder (9.2 per 100 000 person years), or severe depressive episode with psychotic symptoms (3.3 per 100 000 person years) during 2009-2011. The most common co-morbid mental disorders were depressive (38.1%) and anxiety disorders (31.2%). Antipsychotic drugs were prescribed to 62.4% of the patients, 72.0% of the schizophrenia-like disorder patients, 51.7% of the bipolar disorder patients, and 55.4% of the patients with psychotic depression. The most commonly prescribed drugs were quetiapine (29.5%), aripiprazole (19.6%), olanzapine (17.3%), and risperidone (16.6%).
When a severe mental disorder was diagnosed in children and adolescents, the patient was usually also prescribed antipsychotic medication. Clinicians must be aware of the high prevalence of depressive and anxiety disorders among early psychosis patients.
儿童和青少年使用抗精神病药物的情况正在增加，人们越来越关注这些药物的标签外使用和不良反应。本研究旨在调查挪威儿童和青少年严重精神障碍的发病率、精神共病和药物治疗情况。
我们从挪威患者登记处获得了 2009-2011 年首次被诊断为精神分裂样障碍（国际疾病分类，第 10 版代码 F20-F29）、双相情感障碍（F30-F31）或伴有精神病症状的严重抑郁发作（F32.3 或 F33.3）的 0-18 岁儿童和青少年的精神障碍数据。我们从挪威处方数据库获得了精神药物处方的信息。
共有 884 名儿童和青少年（25.1/100000 人年）在 2009-2011 年期间首次被诊断为精神分裂样障碍（12.6/100000 人年）、双相情感障碍（9.2/100000 人年）或伴有精神病症状的严重抑郁发作（3.3/100000 人年）。最常见的共病精神障碍是抑郁（38.1%）和焦虑障碍（31.2%）。抗精神病药物处方占患者的 62.4%，精神分裂样障碍患者的 72.0%，双相情感障碍患者的 51.7%，伴有精神病症状的抑郁患者的 55.4%。最常开的药物是喹硫平（29.5%）、阿立哌唑（19.6%）、奥氮平（17.3%）和利培酮（16.6%）。
当儿童和青少年被诊断出患有严重精神障碍时，通常也会给他们开抗精神病药物。临床医生必须意识到早期精神病患者中抑郁和焦虑障碍的高患病率。
