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Objective: This study aimed to evaluate the frequency of psychotropic medication use and their nature in children under the age of 7 and to determine the predictive variables of using medications.
Methods: Between June 2013 and December 2013, data of children recorded in the Child Psychiatry Department of Ankara Pediatric Hematology Training and Research Hospital was reviewed retrospectively and data of children under the age of 7 was evaluated. Statistical analysis was carried out with SPSS 17.0 (Chicago Inc., 2008). T-test, Chi-square, Fisher’s exact test and binary logistical regression analysis were used where appropriate. p<0.05 was accepted as significant.
Results: Data for a total of 1433 of children aged under 7 was extracted from the 12,320 recorded data sets accumulated during the period of the study (11.6% of all sample). Mean age of children was 4.3±1.5 (1-6 years), the majority of the children was in the 4-6 age group (n=991, 69.2%) and male (n=939, %65.5). There were no psychiatric disorders in 11.9% (n=171) of the children, whereas 88.1% of the total (n=1262) had at least one psychiatric disorder. As far as the psychiatric disorders were concerned, by far the most prominent disorders were the following: “Communication disorders (n=354, 24.7%)”, “Mental Retardation (Full-Scale IQ score ≤69: n=248, 17.3%)” and “Attention deficit hyperactivity disorder (ADHD, n=205, 14.3%)”. The comorbid presence of any psychiatric disorders was found in 13.9% of all children (n=199), by far the most diagnosed one being “Disruptive behavior disorders (n=139, 9.7%)”. Psychotropic medication use was found in 15.7% (n=225) of the sample. Mean age of children who were medicated was 5.4±0.9 (2-6 years). Mean age differences between children who use medication (5.4±0.9), and those who do not (4.17±1.5) was found statistically significant (t=-12,018, p<0.001). The most used psychotropic medication was risperidone monotherapy (4.5%, n=64). Presence of ADHD (X2=7.991, p=0.005) and pervasive developmental disorder (PDD, X2=5.560, p=0.037) had an significant effect on starting medication. The presence of any comorbid psychiatric disorders in children with specific learning disorder (SLD) was found to be an indicator of psychotropic use (X2=22.069, p<0.001). Predictors of medication use were found as follows: age (4-6 age group; p<0.001, Beta=1.602 95% CI 1.250- 2.054); being male (p=0.006, Beta=0.595 95%CI 0.411-0.861); the presence of comorbid psychiatric disorders (p<0.001, Beta=0.071 95%CI 0.046-0.110); the presence of anxiety disorders (p<0.001, Beta=0.073 95%CI 0.047-0.114) and elimination disorders (p=0.005, Beta=0.240 95%CI 0.089-0.0.648).
Conclusion: Being male, in the 4-6 age group, the presence of comorbidity, the presence of anxiety disorders and elimination disorders are found as predictors for using medication in children aged under 7 who are admitted to the Child Psychiatry Department.