Department of Pediatric Pharmacology and Pharmacogenetics, AP-HP, Hôpital Robert Debré, F-75019, Paris, France.
INSERM, Clinical Investigations Center, CIC1426, F-75019, Paris, France.
Epidemiol Psychiatr Sci. 2020 Apr 20;29:e117. doi: 10.1017/S2045796020000293.
Prevalence of the use of antipsychotics (APs) in the paediatric population is globally increasing. The aim of this study was to describe multinational trends and patterns in AP use in children and adolescents in Europe.
This was a dynamic retrospective cohort study comprising all children and adolescents (⩽18 years of age). Data were extracted from five population-based electronic healthcare databases in Europe (Denmark, Germany, Italy, the Netherlands and United Kingdom) from 2000 to 2010. Yearly prevalence and incidence of AP use was expressed per 1000 person-years (PYs).
Prevalence increased from 1.44 to 3.41/1000 PYs (2008) in Denmark and from 2.07 to 4.35/1000 PYs in the NL (2009), moderately increased from 2.8 to 3.24/1000 in UK (2009) and from 1.53 to 1.74/1000 PYs in Germany (2008) and remained low from 0.61 to 0.34/1000 PYs in Italy (2010). Similarly, incidence rates increased from 0.69 to 1.52/1000 PYs in Denmark and from 0.86 to 1.49/1000 PYs in the NL, stabilised from 2.29 to 2.37/1000 PYs in the UK and from 0.79 to 0.80/1000 PYs in Germany and remained low from 0.32 to 0.2/1000 PYs in Italy. AP use was highest in 15-18 year olds and in boys compared to girls. Yet, the use observed in the 5-9 year olds was found to be comparatively high in the NL. Prescriptions of second generation APs, especially risperidone, were privileged but the first generation APs were still prescribed in the youngest.
A steady increase in AP use in children and adolescents was observed essentially in the NL and Denmark. The use in Germany and Italy was lowest among countries. The use of APs under 9 years of age underlines their off-label use and should be carefully monitored as the risk/benefit ratio of these medications remains unclear in young children. AP use was altogether lower in Europe as compared to that reported in North America.
抗精神病药（APs）在儿科人群中的使用在全球范围内呈上升趋势。本研究的目的是描述欧洲儿童和青少年中抗精神病药使用的多国趋势和模式。
这是一项动态回顾性队列研究，纳入了所有儿童和青少年（≤18 岁）。数据从欧洲五个基于人群的电子医疗保健数据库（丹麦、德国、意大利、荷兰和英国）中提取，时间范围为 2000 年至 2010 年。每年抗精神病药使用的患病率和发病率以每 1000 人年（PYs）表示。
丹麦的患病率从 1.44 增加到 3.41/1000 PYs（2008 年），荷兰从 2.07 增加到 4.35/1000 PYs（2009 年），英国的患病率从 2.8 增加到 3.24/1000（2009 年），德国的患病率从 1.53 增加到 1.74/1000 PYs（2008 年），意大利的患病率一直保持在低水平，从 0.61 增加到 0.34/1000 PYs（2010 年）。同样，丹麦的发病率从 0.69 增加到 1.52/1000 PYs，荷兰从 0.86 增加到 1.49/1000 PYs，英国的发病率从 2.29 增加到 2.37/1000 PYs，德国的发病率从 0.79 增加到 0.80/1000 PYs，意大利的发病率一直保持在低水平，从 0.32 增加到 0.2/1000 PYs（2010 年）。抗精神病药的使用在 15-18 岁和男孩中最高，而在女孩中则较低。然而，荷兰的研究发现，5-9 岁儿童的抗精神病药使用相对较高。第二代抗精神病药，特别是利培酮，的处方较多，但第一代抗精神病药仍在最年轻的儿童中使用。
在儿童和青少年中，抗精神病药的使用呈稳步上升趋势，主要在荷兰和丹麦。德国和意大利的使用量最低。9 岁以下儿童使用抗精神病药突出了其超适应证使用，应密切监测，因为这些药物在幼儿中的风险/效益比仍不清楚。与北美报道的情况相比，欧洲的抗精神病药使用总体较低。
