McConkey Roy, Samadi Sayyed Ali, Mahmoodizadeh Ameneh, Taggart Laurence
Institute of Nursing and Health Research, Ulster University, Newtownabbey BT37 0QB, Northern Ireland, UK.
Department of Testing and Evaluation, Autism Section, Iranian Special Education Organization, Tehran 1416935684, Iran.
Int J Environ Res Public Health. 2021 Apr 13;18(8):4120. doi: 10.3390/ijerph18084120.
The use of psychotropic medication in children is increasing worldwide. Children with developmental disabilities seem to be prescribed these medications at a higher rate compared to their non-disabled peers. Little is known about prescribing in non-Western, middle-income studies. In Iran, the file records of 1133 children, aged 2 to 17 years, assessed as having autism spectrum disorder (ASD) or an intellectual disability (ID) in Tehran City and Province from 2005 to 2019 were collated, and information from parental reports of medications was extracted. Upwards of 80% of children with ASD and 56% of those with ID were prescribed a psychotropic medication with around one quarter in each group taking two or more medications. The rates were higher among male children showing difficult-to-manage behaviors such as hyperactivity, but less so for children of fathers with higher levels of education. The lack of alternative management strategies may be a significant driver for the use of psychotropic medications in Iran and other Low and Middle Income countries, despite their known side effects, and their failure to address the developmental needs of the children. Rather, multi-disciplinary, behavioral, therapeutic, and educational interventions are required, but these are not available widely in Iran, although a start has been made.
全球范围内，儿童使用精神药物的情况正在增加。与无发育障碍的同龄人相比，发育障碍儿童似乎更常被开此类药物。在非西方的中等收入国家的用药情况鲜为人知。在伊朗，整理了2005年至2019年在德黑兰市及省份评估为患有自闭症谱系障碍（ASD）或智力残疾（ID）的1133名2至17岁儿童的档案记录，并提取了家长报告的用药信息。超过80%的ASD儿童和56%的ID儿童被开了精神药物，每组中约四分之一的儿童服用两种或更多药物。在表现出多动等难以管理行为的男性儿童中，用药率更高，但父亲受教育程度较高的儿童用药率较低。尽管已知精神药物有副作用且无法满足儿童的发育需求，但缺乏替代管理策略可能是伊朗和其他低收入和中等收入国家使用精神药物的一个重要驱动因素。相反，需要多学科、行为、治疗和教育干预措施，但这些措施在伊朗虽然已经开始实施，但尚未广泛提供。
