Abstract
Background:
Despite the growth in use of psychotropics in preschoolers, little information is available about the clinical characteristics of very young children who receive psychotropics. No information, specific to young children, is available about the prescribing practices of physicians with the most extensive training in child psychopharmacology, i.e., child psychiatrists.
Objective:
The aim of this study was to examine the prevalence and nature of psychotropics prescribed by child psychiatrists to very young children with severe functional impairment secondary to psychiatric pathology, and to examine the clinical context in which these psychotropics were prescribed.
Methods:
The medical charts of 93 children, who were admitted consecutively to a psychiatric unit and who were less than 7 years old, were retrospectively reviewed.
Results:
The children (mean age, 5.4 ± 1.1 years) had a high rate of exposure to abuse or trauma (64.5%). Functional impairment, as measured on the Clinical Global Assessment Scale (CGAS), was high (mean score, 14.4 ± 6.7). Most children (78.5%) received psychotropics during the admission. Children were prescribed antipsychotics (50.6%), psychostimulants(41.9%), and antidepressants (36.6%). Of those on psychotropics, the majority (68.5%) were on 2 or more psychotropics.
Conclusions:
This naturalistic, retrospective study suggests that psychotropics are commonly prescribed to very young children with extremely severe psychopathology and who are in need of inpatient care. Clinical safety and efficacy trials of these agents in very young children are needed.
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