Observed clinical and health services outcomes in pediatric inpatients treated with atypical antipsychotics: 1999-2003.
OBJECTIVE
The aim of this study was to compare clinical and health services outcomes in pediatric inpatients prescribed an atypical antipsychotic (AA) to those not prescribed an AA at discharge.


METHODS
Descriptive statistics, analysis of variance (ANOVA), and, where necessary, analysis of covariance (ANCOVA) were used to compare differences between and within an inpatient group prescribed risperidone, olanzapine, or quetiapine (n=1,131) with an inpatient group not prescribed an antipsychotic at discharge (n=1,741).


RESULTS
The AA treatment group showed greater psychiatric symptom difficulty at admission as measured by the Brief Psychiatric Rating Scale for Children (Mean BPRS-C) than the group not prescribed AAs (40.3 [n=433] vs. 35.2 [n=452], respectively, p<0.001). AA-treated inpatients also had a higher number of mental health outpatient visits during the 6 months prior to admission. Patients receiving AAs (n=1,050) had significantly longer adjusted length of stay (LOS) than those not receiving antipsychotics (n=1,664): 26.4 days versus 22.4 days, respectively (p<0.04).


CONCLUSIONS
The findings suggested pediatric inpatients presenting with greater psychiatric symptom difficulty at hospital admission were more likely to be prescribed an AA. Choice of AA may influence certain clinical and health services outcomes. Additional prospective controlled studies evaluating AA efficacy and safety, including head-to-head comparisons, in pediatric inpatients are warranted.
Flanders
Scott C
SC
Ortho-McNeil Janssen Scientific Affairs, L.L.C., Titusville, New Jersey, USA. sflander@omjus.jnj.com
Findling
Robert L
RL
Youngstrom
Eric A
EA
Pandina
Gahan J
GJ
Rupnow
Marcia F T
MF
Jensik
Sarah E
SE
Carlson
Gabrielle A
GA
D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D010054:Brief Psychiatric Rating Scale; D002648:Child; D002675:Child, Preschool; D003987:Dibenzothiazepines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D000077152:Olanzapine; D010043:Outcome and Process Assessment, Health Care; D010818:Practice Patterns, Physicians'; D000069348:Quetiapine Fumarate; D012189:Retrospective Studies; D018967:Risperidone / Q000627:therapeutic use*; D015430:Weight Gain
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D018967:Risperidone; D000077152:Olanzapine