RESUMEN

OBJECTIVE: The present study used the Pediatric Adverse Events Rating Scale (PAERS) to provide a systematic assessment of adverse events (AEs) related to psychotropic medication use in a clinical sample of young children attending a specialized, early childhood partial hospital program. Study goals were as follows: 1) To describe the frequency and types of specific psychotropic medication-related AEs experienced by very young children (ages 3-7 years) in an acute clinical sample, and 2) to identify the psychotropic medication(s) and/or class(es) associated with the highest frequency of AEs. METHODS: Participants were 158 children (118 males; ages 36-95 months, mean=66 months, SD=14.6 months) who presented to a hospital-based day treatment program for young children with severe emotional and behavioral problems, and were prescribed a psychotropic medication at any point during the hospitalization. Data on AEs related to psychotropic medication were collected using the PAERS from 2011 to 2014. RESULTS: The percentages of children who experienced one or more AEs attributed to a psychiatric medication ranged from 0 (sertraline, melatonin) to 41.2% (fluoxetine), with wide variability in the types AEs reported. The overall frequencies of events caused by a stimulant were similar across the two medications examined (21.4% and 27.7% for mixed amphetamine salts and methylphenidate, respectively), with mood-related difficulties and decreased appetite being the most common AEs reported. The frequencies of AEs caused by an α agonist were also similar across the two medications examined (9.8% and 17.2% for guanfacine and clonidine, respectively), with fatigue as the most commonly reported AE. With respect to the selective serotonin reuptake inhibitor (SSRI) class, there was a trend for fluoxetine to be associated with more AEs (41.2%) than sertraline (for which no AEs were reported). The most common AEs reported for fluoxetine were impulsivity and poor concentration. CONCLUSIONS: The data presented here support existing literature reporting differences in AEs between age groups. More rigorous studies are warranted to further examine the types and frequencies of AEs related to psychotropic medications in very young children.

Asunto(s)

Trastornos Mentales/tratamiento farmacológico , Psicotrópicos/efectos adversos , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Niño , Preescolar , Femenino , Hospitalización , Humanos , Masculino , Psicotrópicos/uso terapéutico , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico

RESUMEN

This study examined the nature and prevalence of diagnostically defined sleep disorders, including Sleep Onset Insomnia (SOI) and Night Waking Insomnia (NWI), in a sample of 183 young children admitted to an early childhood psychiatric day treatment program. A semi-structured diagnostic interview, the Diagnostic Infant and Preschool Assessment, was used to assess for sleep and other psychiatric disorders. Daily sleep diaries and the Child Behavior Checklist were also examined. 41 % of children met criteria for a sleep disorder; 23 % met diagnostic criteria for SOI and 4 % met criteria for NWI, with an additional 14 % meeting criteria for both (SOI + NWI). Sleep-disordered children demonstrated longer latency to sleep onset, longer and more frequent night awakenings, less total sleep, and lower sleep efficiency than non-sleep disordered participants. Diagnosable sleep disorders, particularly SOI, were quite common in this acute clinical sample, exceeding previous estimates obtained in community and pediatric practice samples.

Asunto(s)

Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Lista de Verificación , Niño , Trastornos de la Conducta Infantil/diagnóstico , Trastornos de la Conducta Infantil/epidemiología , Trastornos de la Conducta Infantil/psicología , Trastornos de la Conducta Infantil/terapia , Preescolar , Comorbilidad , Estudios Transversales , Centros de Día , Conflicto Familiar/psicología , Femenino , Humanos , Lactante , Entrevista Psicológica , Masculino , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Estados Unidos

RESUMEN

BACKGROUND: This study focused on the behavioral functioning and treatment outcomes of preschool-aged children who attended a specialized, family focused psychiatric partial hospitalization program. METHOD: Study data were collected between 2002 and 2007. Maternal reports of child behavioral functioning were obtained at program admission and discharge. Maternal parenting stress and psychiatric impairment were assessed at admission. RESULTS: Children's symptom severity decreased from admission to discharge, particularly with respect to externalizing symptoms. Both child age and maternal functioning emerged as predictors of treatment outcome. CONCLUSIONS: Specialized partial hospitalization may be an effective approach to treatment for preschool children with severe psychopathology.