Psychotropic medication utilization in a child and adolescent mental health service.
OBJECTIVE
This study aimed to identify rates and correlates of psychotropic drug utilization in children and adolescents in inpatient and outpatient settings.


METHODS
A retrospective chart review examined 122 inpatient and 126 outpatient charts from a metropolitan child and youth mental health service in Brisbane, Australia.


RESULTS
Inpatients received more psychotropic medication than outpatients (71% vs. 25%; p < 0.01). Patients receiving medication were older, had longer hospital admissions, and more complex presentations, including history of abuse or suicide attempts and more diagnoses (all p < 0.01). Selective serotonin reuptake inhibitors (SSRIs) were the most frequently used drug class (44% inpatients; 14% outpatients), primarily indicated for mood disorders (31%). SSRIs and newer antidepressants (ADs) were used more frequently in patients with a high suicide risk (p < 0.01). Atypical antipsychotics (APs) were also used (inpatients 23%; outpatients 3%), primarily for behavioral disturbances. Half of those receiving medication (51%) received polypharmacy (>1 concurrent drug), with up to four drugs used at one time. Rates of polypharmacy were highest among patients receiving antipsychotics.


CONCLUSIONS
Use of psychotropic medication is frequent in this population. Future research should initially focus on inpatients and intensive treatment settings and examine both safety and efficacy of interventions for depression in young people, atypical antipsychotics for behavioral disturbances, and polypharmacy.
Dean
Angela J
AJ
Kids in Mind Research, Mater Child and Youth Mental Health Service, South Brisbane, QLD 4001, Australia. Angela.Dean@mater.org.au
McDermott
Brett M
BM
Marshall
Robert T
RT
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D000328:Adult; D001315:Australia; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D019338:Polypharmacy; D011619:Psychotropic Drugs / Q000627:therapeutic use*
D011619:Psychotropic Drugs