Department of Hospital Pharmacy, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands.
Eur Child Adolesc Psychiatry. 2023 Aug;32(8):1427-1434. doi: 10.1007/s00787-022-01949-0. Epub 2022 Feb 9.
The Dutch law on youth care (the Youth Act) was implemented from 2015 onwards. One of the government's aims by implementing this new policy was de-medicalization of youths by separating youth mental healthcare from the rest of the healthcare system. A previous study conducted by our research group showed that prevalence rates of antipsychotic drug prescriptions stabilized among Dutch youth in the period 2005-2015, just before the introduction of the Youth Act. In our study, we aimed to describe antipsychotic drug use among Dutch children aged 0-19 years old before and after implementation of the Youth Act (2010-2019).
We analyzed prescription data of 7405 youths aged 0-19 years using antipsychotic drugs between 2010 and 2019, derived from a large Dutch community pharmacy-based prescription database (IADB.nl).
Prevalence rates of antipsychotic drug use per thousand youths decreased significantly in youths aged 7-12 years old in 2019 compared to 2015 (7.9 vs 9.0 p < 0.05). By contrast, prevalence rates increased in adolescent females in 2019 compared to 2015 (11.8 vs 9.5 p < 0.05). Incidence rates increased significantly in adolescent youths in 2019 compared to 2015 (3.9 vs 3.0 p < 0.05), specifically among adolescent girls (4.2 per thousand in 2019 compared to 3.0 per thousand in 2015). Dosages in milligram declined for the most commonly prescribed antipsychotic drugs during the study period. The mean duration of antipsychotic drug use in the study period was 5.7 (95% CI 5.2-6.2) months.
Despite the aim of the Youth Act to achieve de-medicalization of youths, no clear reduction was observed in prevalence rates of antipsychotic drugs or treatment duration in all subgroups. Prevalence rates even increased in adolescent females.
荷兰青少年关爱法（青少年法）于 2015 年开始实施。政府实施这项新政策的目的之一是通过将青少年心理健康护理与医疗体系的其他部分分开，实现青少年医疗去专业化。我们研究小组之前进行的一项研究表明，在青少年法实施之前的 2005 年至 2015 年期间，荷兰青少年的抗精神病药物处方率稳定。在我们的研究中，我们旨在描述青少年法实施前后（2010-2019 年）荷兰 0-19 岁儿童使用抗精神病药物的情况。
我们分析了一个大型荷兰社区药房处方数据库（IADB.nl）中 2010 年至 2019 年间使用抗精神病药物的 7405 名 0-19 岁青少年的处方数据。
与 2015 年相比，2019 年 7-12 岁青少年每千名青少年使用抗精神病药物的比例显著下降（7.9 比 9.0，p<0.05）。相比之下，2019 年青少年女性的使用比例有所上升（11.8 比 9.5，p<0.05）。与 2015 年相比，2019 年青少年的发病率显著增加（3.9 比 3.0，p<0.05），尤其是在青少年女孩中（2019 年为每千人 4.2 例，而 2015 年为每千人 3.0 例）。在研究期间，最常开的抗精神病药物的剂量以毫克计有所下降。在研究期间，抗精神病药物的平均使用时间为 5.7（95%CI 5.2-6.2）个月。
尽管青少年法的目的是实现青少年医疗去专业化，但在所有亚组中，抗精神病药物的使用比例或治疗持续时间都没有明显下降。青少年女性的使用比例甚至有所上升。
