A descriptive study of use of psychotropic drugs in child and adolescent psychiatric illness in an inpatient facility

Objectives: To describe the child and adolescent psychiatric disorders in an inpatient setting and their pharmacological management. Method: The case record files of all the patients who were ≤ 18 years of age, who were admitted to the psychiatry ward of a tertiary care hospital in southern India over a three year period were studied. The following details were recorded - age, gender, diagnosis and the drugs which were prescribed. The drug classes were delineated as follows - antidepressants, antipsychotics, mood stabilizers, anxiolytics/hypnotics and stimulants/non-stimulants for ADHD. Results: A total of 611 patients were admitted during the three year period. 41.6% were females. The mean age was 10.67±5.04 years in males and it was 12.37±4.81 years in females. Neurotic and somatoform disorders were more common in the females (p<0.001), while disorders of psychological development (p=0.023) and behavioural disorders (p<0.001) were more common in males. 44.5% of the cases did not receive any psychotropic medication. The percentage use of the drug classes was as follows - antidepressants- 26%, anxiolytics -18.7%, antipsychotics- 14.7%, mood stabilizers -6.5% and stimulants/non-stimulants- 2%. Antidepressants and anxiolytics were more commonly prescribed in the females (p<0.001), while stimulants were more commonly prescribed in the males (p=0.001). 2.8% of the cases were discharged on 3 drugs. Conclusions: Paediatric admissions due to psychiatric illness were more common in males, although towards adolescence, the percentage of the females increased. The most common diagnoses were behavioural and neurotic disorders, while the most commonly prescribed drugs were antidepressants and anxiolytics. A gender difference was seen in the use of the medications, which correlated with the difference in the disease presentation.