Psychotropic Polypharmacy and Related Factors in Children and Adolescents

We aimed to investigate the clinical characteristics of patients presenting to child and adolescent psychiatry outpatient clinics across different age groups, and to assess the prevalence of polypharmacy along with its associated factors within a clinical sample.

A total of 569 patients with complete file data were included in the study. Psychiatric diagnoses were made by a clinician based on the diagnostic criteria stipulated in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A detailed medical history was obtained for each patient, and their age, gender, education level, parents' age and education level, psychiatric diagnoses, and administered treatments were recorded for further analyses.

Based on a review of the relationship between complaints at presentation and polypharmacy, irritability was more prevalent among polypharmacy users, while domestic problems were more prevalent in those who did not use polypharmacy. Based on our regression analysis; conduct disorder (CD) diagnosis (B=2.405, Exp [B]=11.079, p<0.001), age (B=0.127, Exp [B]=1.136, p=0.008), and any psychiatric comorbidity (B=4.761, Exp [B]=116.874, p<0.001) were the variables most frequently and significantly associated with polypharmacy independent of other variables.

This study's results indicate that the presence of CD, age, and comorbid psychiatric diagnosis significantly increase the risk of polypharmacy. A better understanding of the factors that pave the way toward polypharmacy is critical to reduce unnecessary medication use in children and adolescents.