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Child and adolescent psychiatrists' attitudes and practices prescribing second generation antipsychotics.
J Child Adolesc Psychopharmacol. 2014 Mar; 24(2):90-3.JC

Abstract

OBJECTIVE

The purpose of this study was to examine psychiatrists' attitudes and practices in prescribing second-generation antipsychotics (SGA) to children and adolescents (referred to here as "children") and identify factors associated with off-label SGA use.

METHODS

A survey was mailed to a national, randomly selected sample of 1600 child and adolescent psychiatrists identified by the American Medical Association. Multivariable logistic regression was used to identify factors, including psychiatrists' characteristics, practice characteristics, and psychiatrists' attitudes, that are associated with off-label SGA use (i.e., SGAs used in children with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, conduct disorder, or nonbipolar mood disorders).

RESULTS

The final sample included 340 psychiatrists. Overall, respondents reported higher use and appropriateness of SGAs for United States Food and Drug Administration (FDA)-approved disorders, symptoms of aggression, and older child age. More than one third (36%) of respondents reported some off-label SGA use. Significant predictors of off-label use were: Practicing at inpatient/residential facilities (odds ratio [OR]=4.2, p=0.001); white/non-Hispanic race/ethnicity (OR=0.3, p<0.0001), agreeing that SGAs should be used for ADHD with aggression (OR=7.1, p<0.0001); and agreeing that SGAs should be used for severe delinquent behaviors (OR=1.9, p=0.03).

CONCLUSIONS

Psychiatrists' attitudes about prescribing SGAs to children exhibiting aggressive symptoms were associated with off-label SGA use. Research is needed to understand the construct of aggression, potential interaction effects of aggression with diagnostic criteria, and their impact on SGA use.

Authors+Show Affiliations

1 The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center , Boston, Massachusetts.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24679174

Citation

Rodday, Angie Mae, et al. "Child and Adolescent Psychiatrists' Attitudes and Practices Prescribing Second Generation Antipsychotics." Journal of Child and Adolescent Psychopharmacology, vol. 24, no. 2, 2014, pp. 90-3.
Rodday AM, Parsons SK, Correll CU, et al. Child and adolescent psychiatrists' attitudes and practices prescribing second generation antipsychotics. J Child Adolesc Psychopharmacol. 2014;24(2):90-3.
Rodday, A. M., Parsons, S. K., Correll, C. U., Robb, A. S., Zima, B. T., Saunders, T. S., & Leslie, L. K. (2014). Child and adolescent psychiatrists' attitudes and practices prescribing second generation antipsychotics. Journal of Child and Adolescent Psychopharmacology, 24(2), 90-3. https://doi.org/10.1089/cap.2013.0133
Rodday AM, et al. Child and Adolescent Psychiatrists' Attitudes and Practices Prescribing Second Generation Antipsychotics. J Child Adolesc Psychopharmacol. 2014;24(2):90-3. PubMed PMID: 24679174.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Child and adolescent psychiatrists' attitudes and practices prescribing second generation antipsychotics. AU - Rodday,Angie Mae, AU - Parsons,Susan K, AU - Correll,Christoph U, AU - Robb,Adelaide S, AU - Zima,Bonnie T, AU - Saunders,Tully S, AU - Leslie,Laurel K, PY - 2014/4/1/entrez PY - 2014/4/1/pubmed PY - 2015/3/7/medline SP - 90 EP - 3 JF - Journal of child and adolescent psychopharmacology JO - J Child Adolesc Psychopharmacol VL - 24 IS - 2 N2 - OBJECTIVE: The purpose of this study was to examine psychiatrists' attitudes and practices in prescribing second-generation antipsychotics (SGA) to children and adolescents (referred to here as "children") and identify factors associated with off-label SGA use. METHODS: A survey was mailed to a national, randomly selected sample of 1600 child and adolescent psychiatrists identified by the American Medical Association. Multivariable logistic regression was used to identify factors, including psychiatrists' characteristics, practice characteristics, and psychiatrists' attitudes, that are associated with off-label SGA use (i.e., SGAs used in children with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, conduct disorder, or nonbipolar mood disorders). RESULTS: The final sample included 340 psychiatrists. Overall, respondents reported higher use and appropriateness of SGAs for United States Food and Drug Administration (FDA)-approved disorders, symptoms of aggression, and older child age. More than one third (36%) of respondents reported some off-label SGA use. Significant predictors of off-label use were: Practicing at inpatient/residential facilities (odds ratio [OR]=4.2, p=0.001); white/non-Hispanic race/ethnicity (OR=0.3, p<0.0001), agreeing that SGAs should be used for ADHD with aggression (OR=7.1, p<0.0001); and agreeing that SGAs should be used for severe delinquent behaviors (OR=1.9, p=0.03). CONCLUSIONS: Psychiatrists' attitudes about prescribing SGAs to children exhibiting aggressive symptoms were associated with off-label SGA use. Research is needed to understand the construct of aggression, potential interaction effects of aggression with diagnostic criteria, and their impact on SGA use. SN - 1557-8992 UR - https://www.unboundmedicine.com/medline/citation/24679174/Child_and_adolescent_psychiatrists'_attitudes_and_practices_prescribing_second_generation_antipsychotics_ DB - PRIME DP - Unbound Medicine ER -