Psychotropic Medications Prescribing Patterns for Children and Adolescents in New York's Public Mental Health System

Lyons, John S.; MacIntyre, James C.; Lee, Michael E.; Carpinello, Sharon E.; Zuber, Michael P; Fazio, Marcia L.

doi:10.1023/b:comh.0000022731.65054.3e

Cited by 25 publications

(16 citation statements)

References 19 publications

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“…The prescribing pattern of medications and non-drug interventions and utilization of other services is consistent with the relevant literature [17,21]. In studies of adults attending psychiatric treatment services in Saudi Arabia similar patterns of prescribing, which corresponded with the diagnostic categories, were reported [22,23].…”

Section: Discussionsupporting

confidence: 81%

Pattern of child and adolescent psychiatric disorders among patients consulting publicly-funded child psychiatric clinics in Saudi Arabia

Alhabeeb¹,

Qureshi²,

Al-Maliki³

2012

East Mediterr Health J

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Data about psychiatric problems among young people are scarce in the Gulf countries. This retrospective review of records describes the pattern of child and adolescent psychiatric disorders among patients consulting 3 child psychiatric clinics in Saudi Arabia during the year 2008. Most patients were referred from the public health sector (92.8%). Psychotropic drugs were prescribed for 86.2% of patients and psychotherapy for 55.2%. Maternal perinatal complications and other psychosocial stressors were noted in almost 45.8% of cases. Family history of psychiatric disorder was reported in 31.5% of patients. Psychiatric comorbidity was noted in 40.5% of cases while physical diseases were noted in 29.9%. The outcome was classified as unstable at the last consultation in 17.9% of cases. In a linear regression analysis the only factors significantly associated with unstable outcome were a higher load of symptoms (OR 2.64) and perinatal complications (OR 2.84). Health and Social Services, Ministry of Health, Riyadh, Saudi Arabia (Correspondence to N.A. Qureshi: qureshinaseem@live.com Profil des troubles psychiatriques chez des enfants et adolescents consultant en établissements de soins psychiatriques pour enfants à financement public en Arabie saoudite RÉSUMÉ Les données sur les problèmes psychiatriques des jeunes sont rares dans les pays du Golfe. Le présent examen rétrospectif des dossiers médicaux décrit le profil des troubles psychiatriques des enfants et des adolescents qui consultaient dans trois établissements de soins psychiatriques pour enfants en Arabie saoudite pendant l'année 2008. La plupart des patients venaient du secteur public de la santé (92,8 %). Des médicaments psychotropes ont été prescrits à 86,2 % et une psychothérapie à 55,2 % des patients. Des complications maternelles périnatales et d'autres facteurs de stress psychosociaux ont été observés dans presque 45,8 % des cas. Sur l'ensemble des patients étudiés, 31,5 % avaient des antécédents familiaux de troubles psychiatriques. Une comorbidité psychiatrique a pu être observée dans 40,5 % des cas et physique dans 29,9 %. À l'issue de la dernière consultation, 17,9 % des cas ont été classés comme instables. Dans une analyse de régression linéaire, les seuls facteurs significativement associés à une évolution instable étaient le nombre élevé de symptômes (O.R. 2,64) et les complications périnatales (O.R. 2,84). General Administration for Mental ‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫الثامن‬ ‫املجلد‬ ‫الثاين‬ ‫العدد‬113

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Section: Discussionsupporting

confidence: 81%

Pattern of child and adolescent psychiatric disorders among patients consulting publicly-funded child psychiatric clinics in Saudi Arabia

Alhabeeb¹,

Qureshi²,

Al-Maliki³

2012

East Mediterr Health J

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“…Consistent with prior research (Rawal et al, 2004;Lyons et al, 2004) a substantial number of youth were receiving antipsychotics without a diagnosis of psychosis. For example, a large number of youth diagnosed with ADHD are prescribed antipsychotics.…”

Section: Discussionsupporting

confidence: 74%

“…Twenty-two percent were receiving multiple medications from the same drug class, and 53% were receiving antipsychotic medications. Similarly high rates of psychotropic medication use have been found among children in residential group homes and treatment foster care (Breland-Noble et al, 2004;Najjar et al, 2004;Rawal, Lyons, MacIntyre, & Hunter, 2004;Lyons et al, 2004).…”

Section: Antipsychotic Medication Use Among Childrenmentioning

confidence: 71%

Age, Race, and Gender Differences in Antipsychotic Medication Use Among Children Prior to Entry to Out-of-Home Care

Robst

Armstrong

Dollard

2009

Residential Treatment For Children & Youth

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“…The recommended levels of care consider milieu intensity and service intensity. A more recent instrument, the Child and Adolescent Needs and Strength instrument (CANS), was patterned after the CASPI and has demonstrated concurrent reliability in field testing, and has been used to evaluate service use within public mental health and juvenile justice systems (Lyons, Griffith, Quintenz, Jenuwine, & Sasha, 2003;Lyons et al, 2004). However, both of these instruments are dependent on diagnostic categorization, which is often difficult to achieve in children due to lack of diagnostic clarity as well as high rates of co-morbidities.…”

Section: In Live System Of Care Clinical Settings the Calocus/casii mentioning

confidence: 99%

A Level of Care Instrument for Children's Systems of Care: Construction, Reliability and Validity

et al. 2006

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The Child and Adolescent Level of Care System/Child and Adolescent ServiceIntensity Instrument (CALOCUS/ CASII) is designed to help determine the intensity of services needed for a child served in a mental health system of care. The instrument contains eight dimensions that are rated following a comprehensive clinical evaluation. The dimensions are risk of harm, functionality, co-morbidity (psychiatric, substance abuse, development disability and medical), environmental stressors, environmental supports, the child's resiliency, and the child and family's willingness to engage in treatment. An algorithm connects the ratings to a level of care recommendation. The instrument specifies six levels of care defined flexibly enough to consider whatever services are available. The results of psychometric testing using raters with a broad range of clinical experience and training from four different systems of care around the country are presented. The testing demonstrates excellent reliability when rating vignettes. Using children and adolescents

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Psychotropic Medications Prescribing Patterns for Children and Adolescents in New York's Public Mental Health System

Abstract: The evidence suggests that stimulant and antidepressant are not over-prescribed. However, the use of antipsychotic medications for other indications is a priority for further research.

Cited by 25 publications

References 19 publications

Pattern of child and adolescent psychiatric disorders among patients consulting publicly-funded child psychiatric clinics in Saudi Arabia

Pattern of child and adolescent psychiatric disorders among patients consulting publicly-funded child psychiatric clinics in Saudi Arabia

Age, Race, and Gender Differences in Antipsychotic Medication Use Among Children Prior to Entry to Out-of-Home Care

A Level of Care Instrument for Children's Systems of Care: Construction, Reliability and Validity

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