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Caregivers' Perspectives Regarding the Use of Psychotropic Medication in Children and Young Adults: A Systematic
Phoebe M Downey1, Jack C Collins1, Sarira El-Den1
1The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia.
Background:
The use of psychotropic medications in children and adolescents is increasing worldwide. However, caregivers' perspectives regarding the use of these medications in young people remain underexplored.
Aims:
To explore caregivers' perspectives towards the use of psychotropic medications in the treatment of mental disorders in young people.
Method:
A systematic search was conducted across five databases (MEDLINE (ALL), Embase, PsycINFO, CINAHL, and Scopus) using a search strategy encompassing the concepts 'psychotropic medications', 'mental health', 'attitudes', 'young people', and 'caregivers' to identify relevant records published up to 25 March 2024. Records were screened by title and abstract against predefined criteria, followed by full-text review. Data were synthesised and presented in tables. Quality assessment was conducted using the Mixed Methods Appraisal Tool.
Results:
After screening 1,296 records, 17 studies were eligible for inclusion. Findings were categorised into caregiver attitudes (n = 12), experiences (n = 2), and preferences (n = 9) regarding the use of psychotropic medications in young people. Most caregivers reported negative attitudes, with scepticism, fears of adverse effects and addiction, and doubts regarding efficacy commonly mentioned, including in those whose children had experience with psychotropic medication. Some caregivers were open to the use of psychotropic medications in their children if it was deemed necessary, however, psychotherapy was overwhelmingly the preferred treatment modality. The methodological quality of included studies was mixed; while many met criteria for appropriate sampling and analysis, few used validated measures, and high risk of bias due to non-response and reporting limitations was common.
Conclusion:
This review emphasises the importance of acknowledging and addressing caregiver concerns and actively involving them in the decision-making process. The substantial heterogeneity in study designs, measures, and participant characteristics reinforces the need for future research to employ validated instruments alongside both qualitative and interventional approaches to capture caregiver perspectives and the contextual factors that shape them.
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