Article Type: Original Articles
Psychotropic Drug Use in Preschool and Toddler Age Groups: An Evaluation of Hospital Admissions
Sabide Duygu Uygun, Zeynep Goker, Sadettin Burak Acikel, Gulser Dinc, Ozlem Hekim, Esra Cop, Ozden Sukran Uneri
Objective: This study is aimed to evaluate the frequency of psychotropic drug use in children under age 6, and determine the predictive variables of psychotropic drug use.

Methods: For six months, data of children aged up to 6 admitted to Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Child Psychiatry Department was evaluated. Statistical analyses were performed using SPSS version 17 for Windows. A value of p<0.05 was accepted as significant.

Results: Total of 953 children under age 6 were recruited. Mean age was 3.5 years and 67.7% were male. 83.4% of all had at least one psychiatric disorder. The most common diagnosis was communication disorders (33.5%). Comorbid psychiatric disorder was found in 5.9% of all and the most comorbid diagnosis was an oppositional defiant disorder (3.3%). Psychotropic drug use was found in 7.3%. The most commonly used drug was risperidone (4%). Predictors of treatment were found as aged in 4-5 (p=0.002); male gender (p=0.049); anxiety (p<0.001); attention-deficit/ hyperactivity disorder (ADHD) (p<0.001), and pervasive developmental disorder (p<0.001).

Conclusions: Our results could be useful for preferences of clinicians in treatment of children under age 6, and predictions of scientists working on these age groups in pharmaceutical industry. Multi-centered, large clinic-based studies are needed to constitute a systematic approach for psychopharmacological treatment in these age groups.


1.Hölling H, Kurth BM, Rothenberger A, Becker A, Schlack R. Assessing psychopathological problems of children and adolescents from 3 to 17 years in a nationwide representative sample: results of the German health interview and examination survey for children and adolescents (KiGGS). Eur Child Adolesc Psychiatry 2008;17(1):34-41.

2.Gleason MM, Egger HL, Emslie GJ, Greenhill LL, Kowatch RA, Lieberman AF, et al. Psychopharmacological treatment for very young children: contexts and guidelines. J Am Acad Child Adolesc Psychiatry 2007;46(12):1532-1572.

3.Fanton J, Gleason MM. Psychopharmacology and preschoolers: a critical review of current conditions. Child Adolesc Psychiatr Clin N Am 2009;18(3):753-771.

4.Egger HL, Angold A. Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology. J Child Psychol Psychiatry 2006;47(3-4):313-337.

5.Canino G, Shrout PE, Rubio-Stipec M, Bird HR, Bravo M, Ramirez R, et al. The dsm-iv rates of child and adolescent disordersin puerto rico: prevalence, correlates, service use, and the effects of impairment. Arch Gen Psychiatry 2004;61(1):85-93.

6.Ford T, Goodman R, Meltzer H. The British child and adolescent mental health survey 1999: the prevalence of DSM-IV disorders. J Am Acad Child Adolesc Psychiatry 2003;42(10):1203-1211.

7.Lohr WD, Creel L, Feygin Y, Stevenson M, Smith MJ, Myers J, et al. Psychotropic Polypharmacy Among Children and Youth Receiving Medicaid, 2012-2015. J Manag Care Spec Pharm 2018;24(8):736-744.

8.Turkoglu S. Cocuk ve ergen psikiyatrisi poliklinigine basvuran hastalarda tani dagilimlari [Diagnosis of patients referring to a child and adolescent psychiatry outpatient clinic]. Selcuk Medical Journal 2014;30(3):118-122. [Turkish]

9.Sari BA. Batman’da çocuk psikiyatrisi polikliniğine başvuran hastalarda belirti ve tanı dağılımları [Symptoms and diagnosies of patients referring to a child and adolescent psychiatry outpatient clinic in Batman]. Klinik Psikiyatri Dergisi 2013;16(1):7-17. [Turkish]

10.Durukan I, Karaman D, Kara K, Turker T, Tufan AE, Yalcin O, et al. Diagnoses of patients referring to a child and adolescent psychiatry outpatient clinic. Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2011;24(2):113-120.

11.Aktepe E, Demirci K, Çalışkan AM, Sönmez Y. Symptoms and diagnoses of patients referring to a child and adolescent psychiatry polyclinic. Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2010;23(2):100-108.

12.Aras S, Unlu G, Tas FV. Çocuk ve ergen psikiyatrisi polikliniğine başvuran hastalarda belirtiler, tanılar ve tanıya yönelik incelemeler [Symptoms, diagnoses and diagnostic procedures of patients who presented to the child and adolescent psychiatry outpatient clinic]. Klinik Psikiyatri Dergisi 2007;10(1):28-37. [Turkish]

13.Pihlakoski L, Sourander A, Aromaa M, Rautava P, Helenius H, Sillanpää M. The continuity of psychopathology from early childhood to preadolescence. a prospective cohort study of 3-12-year-old children. Eur Child Adolesc Psychiatry 2006;15(7):409-417.

14.Harpaz-Rotem I, Rosenheck RA. Changes in outpatient psychiatric diagnosis in privately insured children and adolescents from 1995 to 2000. Child Psychiatry Hum Dev 2004;34(4):329-340.

15.Gorker I, Korkmazlar U, Durukan M, Aydogdu A. Çocuk ve ergen psikiyatri kliniğine başvuran ergenlerde belirti ve tanı dağılımı [Symptoms and diagnoses of first-time adolescent applications to a child and adolescent psychiatry out-patient clinic]. Klinik Psikiyatri Dergisi 2004;7(2):103-110. [Turkish]

16.Verhulst FC, Achenbach TM, Van der Ende J, Erol N, Lambert MC, Leung PW, et al. Comparisons of problems reported by youths from seven countries. Am J Psychiatry 2003;160(8):1479-1485.

17.Recart C, Castro P, Alvarez H, Bedregal P. Characteristics of children and adolescents attended in a private psychiatric outpatient clinic. Rev Med Chil 2002;130(3):295-303. [Spanish]

18.Gormez V, Orengul AC, Baljinnyam S, Aliyeva N. Çocuk ve ergen psikiyatrisi polikliniğine başvuran hastalarda tanı dağılımı ve demografik özellikler [Diagnostic and demographic characteristics of patients referred to a child and adolescent psychiatry clinic]. Journal of Mood Disorders 2017;7(1):41-46.

19.Hatice Sevgen F, Altun H. Çocuk ve ergen psikiyatrisi polikliniğine başvuran 0-5 yaş arasi çocuklarin başvuru şikayetleri ve psikiyatrik tanıları. Journal of Mood Disorders 2017;7(4):205-211.

20.Greenhill LL, Jensen PS, Abikoff H, Blumer JL, Deveaugh-Geiss UJ, Fisher C, et al. Developing strategies for psychopharmacological studies in preschool children. J Am Acad Child Adolesc Psychiatry 2003;42(4):406-414.

21.Garfield LD, Brown DS, Allaire BT, Ross RE, Nicol GE, Raghavan R. Psychotropic drug use among preschool children in the Medicaid program from 36 states. Am J Public Health 2015;105(3):524-529.

22.Zito JM, Safer DJ, Gardner JF, Boles M, Lynch F. Trends in the prescribing of psychotropic medications to preschoolers. JAMA 2000;283(8):1025-1030.

23.Vitiello B. Psychopharmacology for young children: clinical needs and research opportunities. Pediatrics 2001;108(4):983-989.

24.Olfson M, Marcus SC, Weissman MM, Jensen PS. National trends in the use of psychotropic medications by children. J Am Acad Child Adolesc Psychiatry 2002;41(5):514-521.

25.Fontanella CA, Hiance DL, Phillips GS, Bridge JA, Campo JV. Trends in psychotropic medication use for Medicaid-enrolled preschool children. J Child Fam Stud 2014;23(4):617-631.

26.Clavenna A, Cartabia M, Sequi M, Costantino MA, Bortolotti A, Fortino I, et al. Burden of psychiatric disorders in the pediatric population. Eur Neuropsychopharmacol 2013;23(2):98-106.

27.Chirdkiatgumchai V, Xiao H, Fredstrom BK, Adams RE, Epstein JN, Shah SS, et al. National trends in psychotropic medication use in young children: 1994–2009. Pediatrics 2013;132(4):615-623.

28.Ozbek A, Bozabali OG. Okul öncesi çocuklarda psikotrop ilaç kullanimi [The use of psychotropic medication in pre-schoolers. Klinik Psikofarmakoloji Bulteni-Bulletin of Clinical Psychopharmacology 2003;13(2):57-64. [Turkish]

29.Coskun M, Zoroglu SS, Ozturk M. Risperidone treatment in preschool children with disruptive behavior disorders: a chart review study. Klinik Psikofarmakoloji Bulteni-Bulletin of Clinical Psychopharmacology 2011;21(1):33-41.

30.Luby J, Mrakotsky C, Stalets MM, Belden A, Heffelfinger A, Williams M, et al. Risperidone in preschool children with autistic spectrum disorders: an investigation of safety and efficacy. J Child Adolesc Psychopharmacol 2006;16(5):575-587.

31.Biederman J, Faraone SV, Monuteaux MC, Feighner JA. Patterns of alcohol and drug use in adolescents can be predicted by parental substance use disorders. Pediatrics 2000;106(4):792-797.

32.Meighen KG, Hines LA, Lagges AM. Risperidone treatment of preschool children with thermal burns and acute stress disorder. J Child Adolesc Psychopharmacol 2007;17(2):223-232.

33.Zuckerman ML, Vaughan BL, Whitney J, Dodds A, Yakhkind A, MacMillan C, et al. Tolerability of selective serotonin reuptake inhibitors in thirty-nine children under age seven: a retrospective chart review. J Child Adolesc Psychopharmacol 2007;17(2):165-174.

34.Avci A, Diler RS, Tamam L. Fluoxetine treatment in a 2.5-year-old girl. J Am Acad Child Adolesc Psychiatry 1998;37(9):901-902.

35.Keim SA, Gracious B, Boone KM, Klebanoff MA, Rogers LK, Rausch J, et al. ω-3 and ω-6 fatty acid supplementation may reduce autism symptoms based on parent report in preterm toddlers. The Journal of nutrition. 2018;148(2):227-35.

36.Connor DF. Preschool attention deficit hyperactivity disorder: a review of prevalence, diagnosis, neurobiology, and stimulant treatment. Journal of Developmental and Behavioral Pediatrics 2002;23(0):S1-S9.

37.Ghuman JK, Arnold LE, Anthony BJ. Psychopharmacological and other treatments in preschool children with attention-deficit/hyperactivity disorder: current evidence and practice. J Child Adolesc Psychopharmacol 2008;18(5):413-447.

38.Riddle MA. New findings from the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS). J Child Adolesc Psychopharmacol 2007;17(5):543-546.

Key words: Psychotropic drug use, preschool, toddler.
Psychiatry and Behavioral Sciences 2019;9(3):112-118
Online ISSN: 2636-834X
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