title: Burden of psychiatric disorders in the pediatric population.
abstract: In order to estimate the burden of mental disorders in a representative Italian pediatric population, an epidemiological study was performed using three administrative databases: a drug prescription, a hospital discharge form, and an outpatient ambulatory visit database. The population target was 1,616,268 children and adolescents under 18 years living in the Lombardy Region, Italy. A youth was defined as a case if during 2008 he/she received at least one psychotropic drug prescription or was hospitalized for a psychiatric disorder (International Classification of Disease codes 290-319), or attended a child neuropsychiatric outpatient unit for a visit and/or a psychological intervention or rehabilitation at least once. Epileptic children were excluded. In all, 63,550 youths (39.3 per 1000; 95%CI 39.1-39.7‰) were identified as users of health care resources for a putative mental disorder. The prevalence was higher in boys than in girls (47.0‰ versus 31.3‰) and the highest value was recorded in children 8 years old (60.2‰). A total of 59,987 youths (37.1‰) attended a child and adolescent neuropsychiatry service at least once, 3605 (2.2‰) were admitted to hospital, and 2761 (1.7‰) received at least one psychotropic drug prescription, 57% of which did not attend a child neuropsychiatry service. In all, 14,741 youths (23.1% of users) had a disorder that required a high intensity of care (e.g. recurrent prescriptions for drugs and/or ambulatory care). The proportion of youths who received care for mental disorders in the Lombardy Region seems lower than in other countries. However, the fact that many children were prescribed psychotropic drugs without the supervision of a child psychiatrist is a reason for concern.
authors.affiliation: Laboratory for Mother and Child Health, Department of Public Health, Mario Negri Institute for Pharmacological Research, Milan, Italy. antonio.clavenna@marionegri.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Clavenna
authors.forename: Massimo
authors.initials: M
authors.lastname: Cartabia
authors.forename: Marco
authors.initials: M
authors.lastname: Sequi
authors.forename: Maria Antonella
authors.initials: MA
authors.lastname: Costantino
authors.forename: Angela
authors.initials: A
authors.lastname: Bortolotti
authors.forename: Ida
authors.initials: I
authors.lastname: Fortino
authors.forename: Luca
authors.initials: L
authors.lastname: Merlino
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bonati
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009313:National Health Programs; D055553:Prescription Drugs / Q000627:therapeutic use; D015995:Prevalence; D012727:Sex Characteristics
chemical_list: D055553:Prescription Drugs