Childhood and adolescence disorders Evaluation of the interrelationships between complaints, diagnoses, and drug usage in an outpatient clinic of pediatric, and adolescent psychiatry

Objective: To investigate interrelationships between complaints, diagnoses, and psychotropic drug usage in ambulatory health care services provided in the outpatient clinics of pediatric and adolescent psychiatry.

Method: In this study, medical files of the patients, who had been examined for the first time between July 2012, and December 2012 in Outpatient Clinics of Pediatric and Adolescent Psychiatry of Uludag University Hospitals of Medical Faculty were evaluated. Medical files of a total of 953 patients [403 (42.3%) female, and 550 (57.7%) male patients] examined during a period of 6 months were retrospectively assessed at the end of 6, and 12 months after referrals. Manifestations, and diagnoses, and also drugs used in the treatment of the patients classified according to their therapeutic groups (antipsychotics, antidepressants etc.), active ingredients and their usage (if any) in combination regimens were entered into standard relevant sections of on-line medical files.

Results: Majority of the cases was of male gender (57.7%), and 35% of the patients were in the age bracket of 7-12 years. The most frequently encountered complaints were determined as naughtiness, and disobedience (19.7%), nervousness (19.5%), hyperactivity (16.2), distraction (14.6%), unhappiness, pessimism, reluctancy, and crying (14.1%). The most frequently detected DSM IV TR diagnoses were attention deficit hyperactivity disorder (ADHD)(18.8%), depression (17.4%), mental health restriction disorder (14.6%), and generalized developmental retardation (11.1%). When diagnoses were evaluated by gender, ADHD, and generalized developmental disorder were more frequently encountered in males, while depression, and generalized anxiety disorder were more often recognized in female patients, which all were statistically significant. Psychotropic drugs were prescribed for 43.4% of the cases. Mostly selective serotonin reuptake inhibitors (21.8%), atypical antipsychotics (14.8%), and psychostimulants (8.3%) were recommended in descending order of frequency. Besides in 98 (10.3%) patients, more than 2 psychotropic drugs were used.

Conclusion: Recognition of frequently detected complaints, and diagnoses, determination of differences in diagnoses between genders, and age groups, evaluation of the drugs used, and their relationship with relevant diagnoses will contribute favourably to the improvement of health care services provided in the outpatient clinics of pediatric and adolescent psychiatry.