Abstract
To the reader—
I hope you will take the time to read through this issue, which contains a number of welcome additions to the literature on antipsychotic treatments and weight gain in pediatric patients.
Oerbeck et al. present their research using the Norwegian Prescription Database to compare the use of antidepressants, antipsychotics, and stimulants in youth placed in residential care, compared with a general population control. “Approximately one in four used antidepressants, antipsychotics, and/or stimulants, suggesting a high prevalence of psychiatric disorders,” the authors write. “Among those who used psychotropics, 47% used antipsychotics, somewhat fewer than among U.S. youth in foster care, where 53% (Zito et al. 2008b) and 65% (Linares et al. 2013) of those medicated were on antipsychotics.”
This Scandinavian data raise similar questions as to the adequacy of care in child welfare settings that we have often seen addressed in this journal from U.S. authors such as Zito, cited earlier. As Oerbeck et al. conclude, “the frequent use of antipsychotics is a concern, as it may reflect that the youth are not provided with the recommended first-line psychological treatments for aggressive behaviors, anxiety/depression, or sleep disorders. This concern is supported by previous literature underlining that children within the child welfare system generally do not receive adequately assessment and nonpharmacological treatment.”
The article from Albers et al. is a valuable counterpoint to Oerbeck et al. Their question: Could the administration of antipsychotics possibly decrease time spent in seclusion and/or restraint for patients aged 5–17 in inpatient settings?
Elsewhere, Bussell et al. and Levy-Shraga et al. present research on managing weight gain in youth being treated with medication. On the one hand, Bussell et al. look at diet and health education in U.S. youth being treated with antipsychotic medications; on the other hand, Levy-Shraga et al. are focused on the use of metformin for weight reduction in Israeli youth treated with mixed dopamine and serotonin receptor antagonists.
Finally, Shaker et al. present incredibly valuable research on attention-deficit/hyperactivity disorder (ADHD) treatment in Egypt. In particular, their article describes an open-label prospective study of atomoxetine in drug-naive Egyptian children with ADHD. The authors note that ADHD prevalence in Arabic countries (including Egypt and Saudi Arabia) appears to be above worldwide averages. I hope you will take the time to read this article, as international perspectives on child and adolescent psychiatric disorders, treatments, and comorbidities can offer so much to our own research and practice.