Psychiatric treatments for children and adolescents preferred by spanish psychiatrists

Abstract

To study the prescription criteria of Spanish psychiatrists treating children and adolescents. Methods: a survey was designed to record their first choice and complementary preferences for pharmacological, psychotherapeutic and psychoeducational interventions in five disorders: autism, depression, separation anxiety, obsessive compulsive and attentiondeficit/hyperactivity disorders. Results: One hundred and nine psychiatrists responded. No distinction was made between children and adolescents. Around 90% recommended all three types of intervention in the five disorders. Only 2-10% would use only one treatment. Antidepressants were the most frequently prescribed drugs (recommended by 58%), followed by anxiolytics (33%), antipsychotics (24%), stimulants (20%), beta-blockers (19%), mood stabilizers (10%) and alpha-adrenergics (4%). Cognitive-behavioral therapy was the most popular approach, recommended by 66%; a third of the interviewees recommended family, support, interpersonal and dynamic psychotherapy. Interestingly, respondents quite frequently prescribe drugs, drug combinations and psychotherapies whose efficacy has not been demonstrated in the disorders in question. Conclusions: The majority of Spanish psychiatrists preferred the combined treatments in all disorders. There seems to be a tendency towards excessive generalization of therapeutic results obtained in adults.

Guidance on the Use of Antidepressants for Depression in Young People: A Survey of the Views of Consultants in Child and Adolescent Psychiatry

“…Psychotropic drug utilisation appears to be greatest in the USA, but evidence from prescription data suggests that the UK saw a particularly large increase (68%) in the number of psychotropic prescriptions for young people under 18 years of age between 2000 and 2002 (Wong et al, 2004). In some studies, antidepressants have been found to be the most commonly prescribed class of psychotropic medication (Dean, McDermot, & Marshall, 2006; Toro, Mur, & Cantó, 2006; Aras, Tas, & Unlu, 2006). Although most attention has focused on the increasing use of antipsychotics and drugs for ADHD, there is also evidence of an increase in antidepressant usage in the years leading up to 2003 (Zito et al, 2002; Najjar et al, 2004; Katz et al, 2008).…”

“…Of the 48 respondents, all prescribed some psychotropic medication but there was wide variation in the volume of prescriptions, although 88% were prescribing antidepressants at that time. In a national Spanish survey of child and adolescent psychiatrists conducted in 2002 (response rate 11.4%), 84% of respondents reported their treatment of choice for depression was a combination of psychotropics (almost always antidepressants) and psychotherapy (Toro et al, 2006). Only 0.9% believed that psychotherapy alone should be used.…”