Problems associated with the diagnosis and the prescribing of anti-psychotic medication in children and adolescents for psychiatric conditions, by non-psychiatric specialists

Malta medical journal

Abigail Cassar Parnis¹  Joseph R. Cassar¹  Nigel Camilleri¹ 

关键词: Sulpiride;    children;    adolescents;    psychiatry;   

DOI  :  

学科分类：医学（综合）

来源: University of Malta * Medical School

【 摘 要 】

Aim: The objective of this study is to assess the accuracy of the diagnosis and appropriateness of antipsychotic medication prescribed to children and adolescents referred to child guidance clinic, and how many of these remained on the said medication after consultant psychiatrist and multidisciplinaryteam review.Method: A retrospective case notes review of all the children referred to a child guidance clinic in the period June 2005 to July 2006 were analysed, looking specifically at the referral tickets, the treatment on first interview with a member of the multidisciplinary team at the clinic, the working diagnosis of the team, and the management plan after at least six months of follow up at child guidance clinic. There was very good interraterreliability between the two observers looking at the case notes.Results: One hundred and fifty four (63.1%) out of a total of 244 children who were referred carried an admission diagnosis, which differed from the working diagnosis after 6 months. A total of 66 children (27%) were started on various types of psychiatric treatment prior to referral. Thirty (45.5%) of these were prescribed sulpiride, an atypical neuroleptic. Following review by the multi-disciplinary team, the medication of 25 (83.3%) of these children was terminated or altered.Conclusion: This report highlights the need of consultation liaison with general practitioners and also Continued Medical Education courses for general practice management in childand adolescent psychiatry. It is advisable that non psychiatric specialists limit the use of antipsychotic medication to childrenand adolescents without expert advice and in addition, should refer all such children with urgency.

【 授权许可】

Unknown