Characteristics of Children Prescribed Antipsychotics: Analysis of Routinely Collected Data.
Characteristics of Children Prescribed Antipsychotics: Analysis of Routinely Collected Data.
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DOI：
10.1089/cap.2017.0003
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发表时间：
2018-04
影响因子：
1.9
通讯作者：
Kerr M
中科院分区：
文献类型：
--
作者：
Brophy S;Kennedy J;Fernandez-Gutierrez F;John A;Potter R;Linehan C;Kerr M
目的：抗精神病药物被许可用于精神病，也被开用于行为控制。本研究旨在探讨儿童处方抗精神病药物的特点和结果。研究方法：一项队列研究使用了1999年至2015年期间居住在威尔士的1，488，936名儿童的全科医生和医院记录与教育记录。使用描述性统计量呈现接受抗精神病药物治疗的儿童的特征，并使用多水平logistic回归和既往事件率（PERR）分析呼吸系统疾病、糖尿病和损伤等结局。结果如下：患有智力障碍/自闭症的儿童更有可能被处方抗精神病药物（2.8%的儿童被处方抗精神病药物[75%患有自闭症]，而没有智力障碍的儿童为0.15%）。那些患有智力残疾/自闭症的人在更小的年龄和更长的时间内服用抗精神病药物。抗精神病药物的使用与所有患者呼吸系统疾病的发生率较高相关（住院PERR：1.55 [95%CI：1.51-1.598]，或治疗患者的发生率每年增加2/100），对于智力障碍/自闭症患者，损伤和住院抑郁的发生率较高。然而，在没有智力障碍/自闭症的人群中，抑郁症的发生率较低（PERR：0.55 [95% CI：0.51-0.59]）。结论：这项工作显示了抗精神病药物的实际使用情况，并提供了有关儿童治疗中可能的不良事件发生率的信息。抗精神病药物主要用于智力障碍/自闭症患者，而不是精神病诊断患者。有证据表明，呼吸系统疾病、癫痫和糖尿病的发病率也较高。在智力障碍/自闭症患者中，住院的抑郁症和受伤是精神病后使用的较高原因。使用抗精神病药物进行行为管理可能会增加医疗保健系统的成本。
Objective: Antipsychotics are licensed for psychosis and are also prescribed for behavior control. This study aims to examine characteristics and outcomes of children prescribed antipsychotics. Methods: A cohort study using general practice and hospital records linked with education records for 1,488,936 children living in Wales between 1999 and 2015. The characteristics of the children who were prescribed antipsychotics are presented using descriptive statistics and outcomes such as respiratory illness, diabetes, and injury were analyzed using multilevel logistic regression and the prior event rate ratio (PERR). Results: Children with intellectual difficulty/autism were more likely to be prescribed antipsychotics (2.8% have been prescribed an antipsychotic [75% with autism] compared with 0.15% of children without intellectual difficulty). Those with intellectual disabilities/autism were prescribed antipsychotics at a younger age and for a longer period. Antipsychotic use was associated with a higher rate of respiratory illness for all (PERR of hospital admission: 1.55 [95% CI: 1.51–1.598] or increase in rate of 2 per 100 per year in those treated), and for those with intellectual difficulty/autism, there was a higher rate of injury and hospitalized depression. However, among those without intellectual difficulty/autism, there were lower rates of depression (PERR: 0.55 [95% CI: 0.51–0.59]). Conclusions: This work shows real-world use of antipsychotics and provides information on the rate of possible adverse events in children treated. Antipsychotics are predominantly used for those with intellectual difficulty/autism rather than those with a psychotic diagnosis. There is evidence that rates of respiratory disease, epilepsy, and diabetes are also higher postantipsychotic use for all. In those with intellectual difficulty/autism, hospital-admitted depression and injury are higher postantipsychotic use. The use of antipsychotics for behavioral management is likely to have increased cost implications to the healthcare system.
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影响因子：
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作者：
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DOI：
10.1111/j.1365-2788.2012.01631.x
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DOI：
10.1016/j.jaac.2016.02.016
发表时间：
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影响因子：
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作者：
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通讯作者：
Vitiello, Benedetto