Department of Child and Adolescent Psychiatry, Trakya University School of Medicine, 22030 Edirne, Turkey.
Medicina (Kaunas). 2019 May 17;55(5):159. doi: 10.3390/medicina55050159.
In recent years, patterns of the use of psychotropic drugs vary with increasing rates of psychiatric presentation and diagnosis in children and adolescents. In this study, we aimed to investigate distributions of current psychiatric symptoms and diagnosis, patterns of the use of psychotropic drugs, and differences according to age and gender in patients presented to a child and adolescent outpatient clinic. All patients aged between 0 and 18 years presenting to a child and adolescent psychiatry outpatient clinic between November 1, 2017 and November 1, 2018 were included in the study. Files of all patients were examined in detail, and patients' demographic characteristics, symptoms, psychiatric diagnoses established according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), psychotropic drugs initiated, and side effect profiles were recorded. Psychiatric symptoms and diagnostic features of the patients were determined, and the differences were investigated according to gender. Clinical characteristics were compared between diagnosed and undiagnosed patients, and between patients with and without drug initiation. Of the 2066 patients, 1298 (62.8%) were male and the mean age was 10.14 ± 4.42 years. The most common symptoms were hyperactivity (23.8%) and inattention (21.6%) in males, inattention (15.1%) and irritability (14.2%) in females, and 79% of the patients received one or more psychiatric diagnoses. The most common psychiatric diagnoses in both genders were attention-deficit hyperactivity disorder (ADHD), specific learning disorder (SLD), and conduct disorder, respectively. Of the patients who received a psychiatric diagnosis, 61.8% were using psychotropic drugs, with the majority of them (71.3%) receiving monotherapy. The most frequently initiated drugs included psychostimulants, antipsychotics, and antidepressants, with 28.7% of the drug user patients receiving multiple drug therapy. Our study indicates that rate of presentation to child and adolescent psychiatry outpatient clinics is increasing, and rates of diagnosis and initiation of psychiatry drugs are high among the presented children. The prevalence of ADHD shows an increase in males and females in our country, and psychiatric polypharmacy has reached significant rates.
近年来，儿童和青少年精神科就诊率和诊断率不断上升，导致精神药物使用模式也发生了变化。在这项研究中，我们旨在调查目前精神症状和诊断的分布情况、精神药物使用模式，以及根据年龄和性别在儿童和青少年门诊就诊患者中的差异。所有于 2017 年 11 月 1 日至 2018 年 11 月 1 日期间在儿童和青少年精神科门诊就诊的 0 至 18 岁患者均被纳入研究。详细检查了所有患者的档案，记录了患者的人口统计学特征、症状、根据精神障碍诊断与统计手册（DSM-5）第五版确定的精神科诊断、开始使用的精神药物和副作用概况。确定了患者的精神症状和诊断特征，并根据性别进行了调查。比较了确诊和未确诊患者、开始用药和未开始用药患者之间的临床特征。在 2066 名患者中，男性 1298 名（62.8%），平均年龄为 10.14 ± 4.42 岁。最常见的症状是男性的多动（23.8%）和注意力不集中（21.6%），女性的注意力不集中（15.1%）和易怒（14.2%），79%的患者接受了一种或多种精神科诊断。男女最常见的精神科诊断分别为注意缺陷多动障碍（ADHD）、特定学习障碍（SLD）和品行障碍。在接受精神科诊断的患者中，61.8%使用了精神药物，其中大多数（71.3%）接受单一药物治疗。最常开始使用的药物包括精神兴奋剂、抗精神病药和抗抑郁药，其中 28.7%的药物使用者接受了多种药物治疗。我们的研究表明，儿童和青少年精神科门诊就诊率不断上升，就诊儿童的精神科诊断率和精神药物使用率较高。在我国，ADHD 的患病率在男性和女性中均有所增加，精神药物的联合使用已达到较高水平。
