Psychopharmacological Treatment of Child and Adolescent Psychiatric Inpatients in Finland

Abstract

Objective:

The objective of this study was to investigate the use of psychopharmacological treatment in child and adolescent psychiatric inpatient treatment in Finland.

Methods:

The study is a cross-sectional study conducted in January 2000. The psychiatrist responsible for the inpatient treatment was asked to fill in a questionnaire for every inpatient who occupied a child or adolescent psychiatric bed during the chosen study day (n = 504 patients). Information on psychopharmacological treatment was obtained for 475 patients.

Results:

Forty-three percent had scheduled medication and 28% had "as required" medication. Of those with scheduled medication, 56% had neuroleptics and 45% antidepressants. In multivariate analysis, older age (13-18 years), involuntary treatment, and psychotic disorder were independently associated with scheduled medication, neuroleptic treatment, and as required medication prescription. Neurolepic treatment was also associated with a very low general functioning level (Children's Global Assessment Scale < 41). A diagnosis of depression and older age were associated with antidepressant treatment. Almost all patients with antidepressant treatment were treated with selective serotonin reuptake inhibitors.

Conclusions:

Compared with data from a similarly conducted study in 1988, there is an increase especially in the use of antidepressant medication in inpatient care. Considering the increasing use of psychopharmacotherapy during the last 10 years as shown in the present study, the lack of research-based data on the efficacy and safety supporting their clinical use is a major problem in the treatment of disabling childhood mental health problems.