Prescribing practices of outpatient child psychiatrists.
OBJECTIVE
This study was designed to assess outpatient child psychiatrists' prescribing practices.


METHODS
Of 1,422 outpatients in two public, university affiliated settings in New York and Ohio, the charts of 146 medicated and 126 nonmedicated randomly selected patients were reviewed for demographic variables, DSM-III-R diagnoses, medications prescribed, and charted prescription rationales.


RESULTS
Fifteen percent of the 800 outpatients seen in a 1-month period in New York, and 19% of the 626 outpatients seen in a 1-year period in Ohio were prescribed medication. Patients medicated by clinic psychiatrists were significantly more likely than nonmedicated patients to be psychotic and to have been hospitalized previously, and significantly less likely to have adjustment disorder. Using standards employed by drug utilization review committees, medications were prescribed appropriately in approximately 90% of cases. Of concern, 65% of patients given antipsychotics in New York and 67% in Ohio were not psychotic; the primary target symptom in such cases was aggression.


CONCLUSIONS
Prescribing practices appeared to be appropriate, although the use of antipsychotic medications in nonpsychotic children is a concern for the field of child psychiatry. The strong similarity of practices in two independent and geographically remote sites suggests the findings are generalizable to providers in other public, university affiliated settings.
Kaplan
S L
SL
Rockland Children's Psychiatric Center, New York State Office of Mental Health, Orangeburg 10962.
Simms
R M
RM
Busner
J
J
D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002648:Child; D002665:Child Psychiatry / Q000706:statistics & numerical data; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D009518:New York / Q000453:epidemiology; D009820:Ohio / Q000453:epidemiology; D010348:Patient Care Team / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use*
D011619:Psychotropic Drugs