Kronström Kim, Kuosmanen Lauri, Ellilä Heikki, Kaljonen Anne, Sourander Andre
Department of Adolescent Psychiatry, University Hospital of Turku, Kaivokatu 18, Turku, 20520, Finland.
Child Adolesc Ment Health. 2018 May;23(2):63-70. doi: 10.1111/camh.12217. Epub 2017 Mar 30.
There have been no comprehensive studies on trends in psychotropic medication use in child and adolescent inpatient settings. The aim of this nationwide study was to report changes in the psychotropic medication given to child and adolescent psychiatric inpatients across Finland and the factors associated with those changes.
We asked the psychiatrist responsible for each inpatient to complete a questionnaire that included questions about the pharmacological treatment and background information. The data were collected on all inpatients on one selected study day in 2000 and 2011. Changes in the use of regular psychotropic medication were studied by comparing the data on 504 patients in 2000 and 412 patients in 2011.
The study showed that there had been a significant increase in the use of psychotropic medication from 2000 to 2011. According to the multivariate analysis, the increase in psychotropic medication was associated with the study year (in 2000 39%, in 2011 58%), but could not be explained by changes in diagnostic profiles, age distribution, suicidality, violence or the Children's Global Assessment Scale scores. The use of combined psychotropic medication increased from 9% in 2000 to 25% in 2011. The increase in the use of antipsychotics among child inpatients was particularly noteworthy, with an increase from 10% to 32%.
There is a need for evidence-based studies to clarify recommendations for indications and treatment practices when using psychotropic medication in children and adolescents. Cross-cultural studies of the use of psychotropic medication are warranted.
目前尚无关于儿童和青少年住院患者使用精神药物趋势的全面研究。这项全国性研究的目的是报告芬兰全国儿童和青少年精神科住院患者使用精神药物的变化情况以及与这些变化相关的因素。
我们要求负责每位住院患者的精神科医生填写一份问卷，其中包括有关药物治疗和背景信息的问题。在2000年和2011年选定的一个研究日收集了所有住院患者的数据。通过比较2000年504例患者和2011年412例患者的数据，研究了常规精神药物使用的变化情况。
研究表明，从2000年到2011年，精神药物的使用有显著增加。根据多变量分析，精神药物的增加与研究年份有关（2000年为39%，2011年为58%），但无法用诊断特征、年龄分布、自杀倾向、暴力行为或儿童总体评估量表得分的变化来解释。联合使用精神药物的比例从2000年的9%增加到2011年的25%。儿童住院患者中抗精神病药物使用的增加尤为显著，从10%增加到32%。
需要进行基于证据的研究，以明确儿童和青少年使用精神药物时的适应症和治疗方法建议。有必要对精神药物的使用进行跨文化研究。
