Clinical use of second-generation antipsychotics in children
, , , , und | 20. Nov. 2017
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Article Category: research-article
Online veröffentlicht: 20. Nov. 2017
Seitenbereich: 77 - 88
DOI: https://doi.org/10.21307/sjcapp-2017-009
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© 2017 Kirsi Kakko et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
FIGURE 1.
FIGURE 2.
FIGURE 3.
Recommendations for monitoring second-generation antipsychotic treatment according to National Institute for Health and Care Excellence (NICE), American Academy of Child and Adolescent Psychiatry (AACAP), and Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) (39,40,42)
| Follow-ups | |||||
|---|---|---|---|---|---|
| Issued by | Baseline | 1 | 2 | 3 | 4 |
| NICE | Weekly (first 6 weeks) | 12 weeks | Every 6 months | ||
| Growth chart Includes weight and height | Growth chart, MD, efficacy, side-effects | Growth chart, MD, RR, pulse, fb-gluc, HbA1c, lipids, prolactin, physical health, efficacy, side effects | Growth chart, MD, WHC, RR, pulse, fb-gluc, HbA1c, lipids, prolactin, physical health, efficacy, side effects | – | |
| AACAP | Regular intervals | ||||
| Family history, BMI, WC, RR, pulse, fb-gluc, lipids, MD | BMI, RR, pulse, fb-gluc (HbA1c if needed), lipids If significant weight changes and/or a family history indicating risk | – | – | – | |
| CAMESA | 1, 2, 9 months | 3 months | 6 months | 1 year | |
| Growth chart, BMI, WC, RR, NEU, fb-gluc, insulin, lipids, ASAT, ALAT, TSH (with quetiapine), prolactin | Growth chart, BMI, WC, RR, NEU | Growth chart, BMI, WC, RR, NEU, fb-gluc, insulin, lipids, prolactin | Growth chart, BMI, WC, RR, NEU, fb-gluc, insulin, lipids ASAT, ALAT, TSH (with quetiapine) | Same as baseline | |
International Statistical Classification of Diseases and Related Health Problems, 10th Revision, diagnoses of second-generation antipsychotic (SGA)-treated children (n=133)
| Diagnoses | ICD-10 class | % |
|---|---|---|
| Hyperkinetic disorders | F90 | 50 |
| Conduct/mixed conduct and emotional disorder | F91-92 | 40 |
| Pervasive developmental disorders | F84 | 30 |
| Obsessive compulsive disorder | F42 | 13 |
| Disorders of social functioning with onset specific to childhood and adolescence ICD-10, | F94 | 13 |
| Reaction to severe stress/adjustment disorders | F43 | 10 |
| Tic disorders | F95 | 8 |
| Emotional disorder with onset specific to childhood | F93 | 7 |
| Disorders of psychological development | F80-82 | 7 |
| Depressive episode | F32 | 6 |
| Bipolar affective disorder | F31 | 5 |
| Psychotic disorders | F23, F29 | 5 |
| Mixed specific developmental disorders | F83 | 5 |
| Other mood (affective) disorders | F38 | 5 |
| Phobic and other anxiety disorders | F40-41 | 3 |
| Dissociative (conversion) disorders | F44 | 3 |
| Other behavioural and emotional disorders with onset usually occurring in childhood and adolescence Reactive attachment disorder F94.1 (n=5), other childhood disorders of social functioning F94.8 (n=12) | F98 | 2 |
| Eating disorders | F50 | 1 |
| Unspecified mental retardation | F79 | 1 |
Family background of the second-generation antipsychotic-treated children
| All (%) | PDD/DD (%) | Non-PDD/DD (%) | ||
|---|---|---|---|---|
| Family status (n=133) | <.001 | |||
| Biological parents | 37 | 57 | 26 | |
| Parental separation | 40 | 36 | 42 | |
| Foster home | 18 | 6 | 24 | |
| Other (e.g. adoption) | 5 | 0 | 8 | |
| Number of siblings (n=126) | NS | |||
| None | 21 | 23 | 20 | |
| One | 38 | 40 | 37 | |
| Two or more | 41 | 36 | 43 | |
| Mother’s working status (n=133) | .018 | |||
| Working at least part time | 53 | 68 | 45 | |
| Other or not known | 47 | 32 | 55 | |
| Father’s working status (n=133) | NS | |||
| Working at least part time | 57 | 64 | 54 | |
| Other or not known | 43 | 36 | 47 | |
| Alcohol/drugs (n=83) | 60 | 44 | 71 | .021 |
| Psychiatric history of first-degree relatives | ||||
| Schizophrenia, bipolar disease or other psychosis (n=67) | 33 | 15 | 45 | .016 |
| Depression (n=88) | 67 | 61 | 72 | NS |
| Suicide (n=133) | NS | |||
| Committed | 2 | 2 | 2 | |
| At least one attempt | 7 | 2 | 9 | |
| Child exposed to violence (n=133) | 41 | 30 | 48 | .065 |
| Exposed to domestic violence | 11 | 4 | 15 | |
| Been object of physical punishment or other domestic violence | 12 | 13 | 12 | |
| Both exposed and been object | 11 | 6 | 13 | |
| Other kind of violence exposure (e.g. war experiences) | 8 | 6 | 8 |