Dec 4 Despite concerns that too many U.S. young
people are using prescription psychiatric drugs, a U.S. study
said that just one in seven teens with a mental disorder has
been prescribed medication.
Researchers from the National Institutes of Health (NIH),
which funded the study, said there was no compelling evidence
for either misuse or overuse of psychotropic medications, which
include stimulants for attention-deficit hyperactivity disorder
(ADHD), antidepressants and antipsychotics.
"Certain the use of psychiatric medications has been
increasing in children and adolescents over the years," said
Benedetto Vitiello from the NIH, who worked on the study.
"(But) most of the adolescents who met the criteria for a
condition were not receiving medication, which suggests that
they were being treated with something else, maybe
psychotherapy, or maybe they were not even treated," he added.
"This data may suggest that there may be underuse (of
psychiatric medications) in some cases."
The findings, which appeared in the Archives of Pediatrics &
Adolescent Medicine, are based on interviews with more than
10,000 teens and their parents, most of whom had at least a high
school education and were middle class or above. The interviews
were conducted between 2001 and 2004.
Vitiello and his colleagues found 2,350 teens had any type
of mental disorder, including anxiety, eating disorders,
depression and ADHD.
Just over 14 percent of youth with a mental disorder had
been prescribed a psychiatric drug in the past year. That varied
by drug and type of disorder: one in five teens with ADHD was
recently prescribed stimulants, for example, compared to one in
22 with anxiety who were on an antidepressant.
In youth without signs of a current disorder, 2.5 percent
had been prescribed a psychiatric drug recently - most of whom
had some signs of distress or a past mental disorder, the
The study did not keep track of how many teens were taking
drugs they weren't prescribed, such as misusing stimulants as
Because the interviews were conducted in the early 2000s,
the findings may not mirror current trends in prescribing to
youth, the researchers warned.
In addition, the report includes a disproportionate number
of children from high income families, said David Rubin, from
Children's Hospital in Philadelphia, who wrote a commentary on
Children on Medicaid, the government-sponsored health
insurance program for the poor, tend to take more psychiatric
drugs. That's especially true among the smaller subset of youth
in foster care, of whom 12 percent were prescribed
antipsychotics in 2007, according to Rubin's past research.
Medicaid enrollees get mental health services for free, but
where they can access them, those services are often skewed
toward medication instead of talk therapy, Rubin said.
For middle-class youth, insurance co-pays may present more
of a barrier to any type of care, including medication.
"The concern regarding the overtreatment versus
undertreatment of mental health conditions is really a difficult
problem to answer," said Robert Fortuna from the University of
Rochester Medical Center.
"It really requires a more nuanced view that we are possibly
overprescribing in some situations and missing opportunities to
treat in other situations."
(Reporting from New York by Genevra Pittman at Reuters Health;
editing by Elaine Lies)