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Published Online, 24 January 2006, www.theannals.com, DOI 10.1345/aph.1G203.
 The Annals of Pharmacotherapy: Vol. 40, No. 2, pp. 205-211. DOI 10.1345/aph.1G203
© 2006 Harvey Whitney Books Company.
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PSYCHIATRY

Diagnoses and Antipsychotic Treatment Among Youths in a Public Mental Health System

Nick C Patel, PharmD PhD

Assistant Professor, Department of Pharmacy Practice, College of Pharmacy, and Department of Psychiatry, University of Cincinnati, Cincinnati, OH

M Lynn Crismon, PharmD

Behrens Inc. Centennial Professor, Pharmacy Practice Division, College of Pharmacy, The University of Texas at Austin, Austin, TX

Alan Shafer, PhD

Research Specialist, Texas Health and Human Services Commission, Austin

Reprints: Dr. Patel, University of Cincinnati, PO Box 670004, 3225 Eden Ave., Cincinnati, OH 45267-0004, fax 513/558-0731, nick.patel{at}uc.edu

BACKGROUND: The use of antipsychotics, namely newer atypical agents, has increased significantly in children and adolescents. It is important to examine diagnoses associated with antipsychotic treatment in youths.

OBJECTIVE: To evaluate trends in psychiatric diagnoses of children and adolescents in a public mental health system who were prescribed antipsychotics.

METHODS: Children and adolescents, up to the age of 19 years, who were prescribed an antipsychotic between January 1998 and December 2001 were identified using the Texas Medicaid Vendor Drug database. Patient identification numbers were then cross-linked to the Client Assignment and Registration database of the Texas Department of Mental Health and Mental Retardation to extract diagnostic data.

RESULTS: Disruptive behavioral disorders accounted for the highest percentage (35%) of diagnoses associated with children and adolescents receiving antipsychotic treatment and mental healthcare services. Depressive disorders were the second most common diagnosis (18%), and bipolar disorders accounted for roughly 12% of all diagnoses. Approximately 3% of children and adolescents did not have a psychiatric diagnosis. The percentage of youths with comorbid psychiatric diagnoses decreased over time.

CONCLUSIONS: Although disruptive behavioral disorders accounted for a large percentage of antipsychotic use in this population, these findings suggest that antipsychotics are being used to treat other psychiatric diagnoses, for which limited supporting data exist. Future research in children and adolescents should aim to provide needed efficacy and safety data of antipsychotics across the spectrum of neuropsychiatric disorders.

Key Words: adolescents, antipsychotics, children

Published Online, January 24, 2006. www.theannals.com, DOI 10.1345/aph.1G203




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Copyright © 2006 by Harvey Whitney Books Company.