A three-country comparison of psychotropic medication prevalence in youth

<p>Abstract</p> <p>Background</p> <p>The study aims to compare cross-national prevalence of psychotropic medication use in youth.</p> <p>Methods</p> <p>A population-based analysis of psychotropic medication use based on administrative claims data for the year 2000 was undertaken for insured enrollees from 3 countries in relation to age group (0–4, 5–9, 10–14, and 15–19), gender, drug subclass pattern and concomitant use. The data include insured youth aged 0–19 in the year 2000 from the Netherlands (n = 110,944), Germany (n = 356,520) and the United States (n = 127,157).</p> <p>Results</p> <p>The annual prevalence of any psychotropic medication in youth was significantly greater in the US (6.7%) than in the Netherlands (2.9%) and in Germany (2.0%). Antidepressant and stimulant prevalence were 3 or more times greater in the US than in the Netherlands and Germany, while antipsychotic prevalence was 1.5–2.2 times greater. The atypical antipsychotic subclass represented only 5% of antipsychotic use in Germany, but 48% in the Netherlands and 66% in the US. The less commonly used drugs e.g. alpha agonists, lithium and antiparkinsonian agents generally followed the ranking of US>Dutch>German youth with very rare (less than 0.05%) use in Dutch and German youth. Though rarely used, anxiolytics were twice as common in Dutch as in US and German youth. Prescription hypnotics were half as common as anxiolytics in Dutch and US youth and were very uncommon in German youth. Concomitant drug use applied to 19.2% of US youth which was more than double the Dutch use and three times that of German youth.</p> <p>Conclusion</p> <p>Prominent differences in psychotropic medication treatment patterns exist between youth in the US and Western Europe and within Western Europe. Differences in policies regarding direct to consumer drug advertising, government regulatory restrictions, reimbursement policies, diagnostic classification systems, and cultural beliefs regarding the role of medication for emotional and behavioral treatment are likely to account for these differences.</p

Off-label psychopharmacologic prescribing for children: History supports close clinical monitoring

The review presents pediatric adverse drug events from a historical perspective and focuses on selected safety issues associated with off-label use of medications for the psychiatric treatment of youth. Clinical monitoring procedures for major psychotropic drug classes are reviewed. Prior studies suggest that systematic treatment monitoring is warranted so as to both minimize risk of unexpected adverse events and exposures to ineffective treatments. Clinical trials to establish the efficacy and safety of drugs currently being used off-label in the pediatric population are needed. In the meantime, clinicians should consider the existing evidence-base for these drugs and institute close clinical monitoring

Safeguarding the best interests of children of incarcerated mothers

Children and adolescents' mental health risk and resilience arise from a complex interplay of factors on several socio-ecological levels. However, little is known about the factors that shape the mental health of refugee youth living in refugee camps close to ongoing conflict. We conducted a cross-sectional study with a representative sample of 217 Burundian refugee children aged 7-15 and their mothers residing in refugee camps in Tanzania to investigate associations between risk, protective and promotive factors from various ecological levels (individual, microsystem, exosystem), and children's post-traumatic stress disorder (PTSD) symptoms, internalizing and externalizing problems, and prosocial behavior. Data were collected using structured clinical interviews and analyzed using multiple regression models. Exposure to violence across all contexts and engagement coping were risk factors for PTSD symptoms and internalizing problems, while only violence by mothers seemed to increase children's vulnerability for externalizing problems. A differential impact of violence exposures on prosocial behavior was observed. Higher-quality friendships appeared to protect youth from PTSD symptoms and externalizing problems, while they also promoted children's prosocial behavior, just as mothers' social support networks. Prevention and intervention approaches should integrate risk, protective and promotive factors for refugee youth's mental health across multiple ecological contexts and take into account context-specific and adaptive responses to war and displacement

Special section on psychopharmacology trials in children and adolescents

Abstract For the first time, we publish a special section of four related articles in the online, open-access journal Child and Adolescent Psychiatry and Mental Health.</p

Die Ehrungen der Deutschen Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie e. V. (DGKJP) und ihrer Vorgängerorganisationen

Das Forschungsprojekt 'Aufarbeitung der Ehrungen der DGKJP' hat alle von der Fachgesellschaft zwischen 1950 (Wiedergründung nach Kriegsende) und 1990 (deutsche Wiedervereinigung) geehrten Personen auf die Angemessenheit der Ehrung überprüft. Insbesondere wurde untersucht, ob die Geehrten im Nationalsozialismus gegen die ärztliche Berufsethik verstoßen hatten, wie z. B. Erstellung von T4-Gutachten, die in ihrem Ergebnis zum Tod der Patientinnen und Patienten führten, Arbeit in 'Kinderfachabteilungen', in denen Kinder gezielt durch Gabe von Medikamenten getötet wurden und jede Form von nichttherapeutischen Menschenversuchen. 1957 wurde erstmalig die Heinrich-Hoffmann-Medaille verliehen und ab 1963 die Ehrenmitgliedschaft. Von 1957 bis 1990 wurden 19 Ehrenmitgliedschaften und neun Heinrich-Hoffmann-Medaillen verliehen, somit an 27 Persönlichkeiten (eine erhielt beide Auszeichnungen). Bei drei geehrten Persönlichkeiten wurden Verstöße gegen die ärztliche Berufsethik identifiziert. Nach langen internen Diskussionen hatte sich die DGKJP bereits 2002 und 2007 von diesen drei Personen distanziert: Elisabeth Hecker (1895-1986), Hans-Alois Schmitz (1899-1973) und Werner Villinger (1887-1961). Die von Villinger propagierte 'praktische Unerziehbarkeit', das 'Minderwertigkeitsdenken', war der gemeinsame gedankliche Hintergrund. Öffentlich wurden diese Distanzierungen bisher kaum wahrgenommen, bis 2021 gab es dazu lediglich kurze Mitteilungen im Mitteilungsblatt. Elf Geehrte waren Mitglied der NSDAP ohne nachweisliche Ethikverstöße. Diskutiert werden drei weitere Geehrte, bei denen Ethikverstöße weder definitiv auszuschließen noch definitiv festzustellen sind