Current Pattern of Psychiatric Comorbidity and Psychotropic Drug Prescription in Child and Adolescent Patients

Attention Deficit Hyperactivity Disorder and Psychiatric Comorbidities

Aim: This study aims to obtain current information on the clinical features of attention deficit hyperactivity disorder cases, comorbid psychiatric disorders and psychiatric drug use. Methods: All patients between the ages of 6 and 18 years who were admitted to our outpatient clinic and diagnosed with attention deficit hyperactivity disorder were included in the study. The files of the patients were examined and their demographic characteristics, symptoms, psychiatric diagnoses and drug profiles were recorded. The pattern of the psychiatric disorders accompanied by attention deficit hyperactivity disorder cases and the differences according to age and gender were analyzed. The differences were determined in patients with psychiatric comorbidity compared to those without. Result: The mean age of the 777 patients included in the study was 11.1±2.94 and 76.6% were boys. 60.9% of attention deficit hyperactivity disorder patients had comorbid psychiatric disorders. The most common psychiatric comorbidities were specific learning disability (23.6%), oppositional defiant disorder (12.9%) and conduct disorder (12.1%). There was no difference between the genders in terms of the incidence of psychiatric comorbidities. The rate of psychiatric comorbidity was significantly higher in adolescents than in children. A psychotropic medication was used in 86.4% of the cases and psychotropic polypharmacy was present in 31.5%. The rate of polypharmacy was significantly higher in the group with psychiatric comorbidity. Conclusion: Attention deficit hyperactivity disorder is frequently accompanied by other psychiatric disorders and the psychiatric comorbidity leads to a more complicated clinical profile. Approximately one-third of attention deficit hyperactivity disorder patients have psychiatric polypharmacy and these patients should be carefully monitored. Primary care physicians who are frequently confronted with attention deficit hyperactivity disorder cases should be careful about psychiatric comorbidities. Keywords: Child psychiatry, attention deficit hyperactivity disorder, mental disorders, Family practice

The awareness rate of mental health knowledge Among Chinese adolescent: A systematic review and meta-analysis

BACKGROUND

Mental health knowledge is an important part of mental health literacy, which is related to one's attitude and coping style when facing mental illness. The awareness rate of mental health knowledge among adolescents is an effective index to evaluate the effect of school mental health education, and the awareness rate of mental health knowledge among Chinese adolescents has not been effectively evaluated.

METHODS

Two electronic databases for English language and 3 electronic databases for Chinese language were searched for relevant studies. Meta-analysis was conducted to analyze the awareness rate among Chinese adolescents. The normal distribution test was conducted using 5 methods. Homogeneity test was conducted, and I > 50% indicates existence of heterogeneity and in this case, the random model was adopted; otherwise, we adopt the fixed model. Funnel plot and Egger test was used to confirm whether publication bias existed.

RESULTS

Seventeen studies were included in this study, comprising 22,164 students from different stages of education (10,437 senior middle-school students, 5589 junior middle-school students, and 6138 college students). The awareness rate of mental health knowledge among Chinese adolescents was only 66%; for university students and middle-school students, their awareness rate was 73% and 61%, respectively. The awareness rate among senior middle-school students was as low as that of junior middle-school students. The awareness rate among college students in developed regions was higher than that in developing regions.

CONCLUSIONS

The awareness rate of mental health knowledge among Chinese adolescents was lower than the goal set in the national mental health work plan. There are gaps in mental health education in different developed areas. The mental health education among adolescent in Chinese mainland needs to be further strengthened.