Fourteen-year trends in the prescribing patterns of pediatric bipolar patients discharged from two public mental hospitals in Taiwan

IF 2.8 3区医学 Q2 PSYCHIATRY

Asia‐Pacific Psychiatry Pub Date : 2022-12-30 DOI:10.1111/appy.12525

Ching-Hua Lin MD, PhD, Hung-Yu Chan MD, PhD, Hsin-Yi Lin MD, Cheng-Chung Chen MD, PhD

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引用次数: 1

Abstract

Introduction

The management of pediatric bipolar disorder (PBD) requires pharmacotherapy to control acute symptoms, reduce relapse, prevent suicide, and improve psychosocial functioning. The purpose of this study was to investigate prescribing patterns among PBD patients discharged from two public mental hospitals in Taiwan, from 2006 to 2019.

Methods

PBD patients discharged from the two study hospitals, from 1 January 2006 to 31 December 2019 (n = 420), were included in the analysis. Prescribed drugs at discharge, including mood stabilizers (i.e., lithium, valproate, carbamazepine, and lamotrigine), antipsychotics (i.e., second- and first-generation antipsychotics, SGAs and FGAs), and antidepressants, were explored. Complex polypharmacy was defined as the use of 3 or more agents among the prescribed drugs. Time trends of each prescribing pattern were analyzed using the Cochran-Armitage Trend test.

Results

The most commonly prescribed psychotropic agents were SGAs (76.0%), followed by valproate (65.7%) and FGAs (24.8%). The prescription rates of SGAs, antidepressants, antidepressant plus antipsychotic, and antidepressant without mood stabilizer significantly increased over time, whereas the prescription rates of mood stabilizers, lithium, and FGAs significantly decreased.

Discussions

Prescribing patterns changed greatly for PBD patients over time. However, much more evidence supporting the effectiveness of psychotropic agents in PBD patients is required.

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台湾两所公立精神病院出院儿童躁郁症患者14年处方模式之趋势

儿童双相情感障碍(PBD)的治疗需要药物治疗来控制急性症状，减少复发，预防自杀，并改善心理社会功能。本研究旨在探讨2006年至2019年台湾两所公立精神病院出院PBD患者的处方模式。方法将2006年1月1日至2019年12月31日从两家研究医院出院的PBD患者(n = 420)纳入分析。出院时的处方药物，包括情绪稳定剂(如锂、丙戊酸、卡马西平和拉莫三嗪)、抗精神病药(如第二代和第一代抗精神病药、SGAs和FGAs)和抗抑郁药。复杂多药定义为在处方药物中使用3种或3种以上的药物。采用Cochran-Armitage趋势检验分析各处方模式的时间趋势。结果最常使用的精神药物是SGAs(76.0%)，其次是丙戊酸酯(65.7%)和FGAs(24.8%)。随着时间的推移，SGAs、抗抑郁药、抗抑郁药加抗精神病药和抗抑郁药不含情绪稳定剂的处方率显著增加，而情绪稳定剂、锂和FGAs的处方率显著降低。随着时间的推移，PBD患者的处方模式发生了很大变化。然而，需要更多的证据来支持精神药物对PBD患者的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia‐Pacific Psychiatry PSYCHIATRY-

CiteScore

7.80

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Asia-Pacific Psychiatry is an international psychiatric journal focused on the Asia and Pacific Rim region, and is the official journal of the Pacific Rim College of Psychiatrics. Asia-Pacific Psychiatry enables psychiatric and other mental health professionals in the region to share their research, education programs and clinical experience with a larger international readership. The journal offers a venue for high quality research for and from the region in the face of minimal international publication availability for authors concerned with the region. This includes findings highlighting the diversity in psychiatric behaviour, treatment and outcome related to social, ethnic, cultural and economic differences of the region. The journal publishes peer-reviewed articles and reviews, as well as clinically and educationally focused papers on regional best practices. Images, videos, a young psychiatrist''s corner, meeting reports, a journal club and contextual commentaries differentiate this journal from existing main stream psychiatry journals that are focused on other regions, or nationally focused within countries of Asia and the Pacific Rim.