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Antipsychotic prescribing in youths: a French community-based study from 2006 to 2013

Abstract

The objectives were to explore in a community-based sample of persons aged 0–25 years: (1) trends in antipsychotic prescribing, (2) characteristics of the zone of residence associated with antipsychotic prescribing rates, and (3) the pattern of antipsychotic prescribing. The study was performed using reimbursement data from the French Insurance Healthcare system. Prescribing trends were investigated over the period 2006–2013. An ecological design was used to assess the impact of the socio-economical and health resource characteristics of the zone of residence (n = 96 administrative subdivisions of French territory) on antipsychotic prescribing rates. The pattern of antipsychotic prescribing was explored in a cohort of youths newly treated with antipsychotics. Over the period 2006–2013, antipsychotic dispensing rates were stable in persons aged 0–25 years (4.8 per 1,000 in 2006 and 4.9 per 1,000 in 2013). First-generation antipsychotic dispensing rates decreased from 3.1 to 2.6 per 1,000 (OR = 0.96, 95 % CI 0.94–0.98), while second-generation antipsychotic dispensing rates increased from 2.7 to 3.4 per 1,000 (OR = 1.03, 95 % CI  1.01–1.05). Antipsychotic prescribing rates were impacted by health resource characteristics of the zone of residence in children aged 10 years and under and by socio-economical characteristics in those aged 16–20 years. In all the age groups, antipsychotics were principally started by hospital practitioners (47 %) and general practitioners (34 %). The rates of psychostimulants concomitantly prescribed with antipsychotics were lower than 5 %. In conclusion, rates of youths exposed to second-generation antipsychotics are still rising. The impact of environmental characteristics on antipsychotics prescribing and appropriateness of these prescriptions in youths should be further investigated.

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Acknowledgments

This is an independent study funded by autonomous resources of INSERM U657. The authors thank Ray Cooke for supervising the English of this manuscript. They acknowledge the reviewers of a previous version of the manuscript for their thoughtful comments.

Ethical standard

The study was performed in accordance with the ethical and security standards of the French National Data Protection Authority (Commission Nationale de l’Informatique et des Libertés, CNIL). It was therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflict of interest

The authors have no conflicts of interest to disclose.

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Correspondence to Hélène Verdoux.

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Verdoux, H., Pambrun, E., Cortaredona, S. et al. Antipsychotic prescribing in youths: a French community-based study from 2006 to 2013. Eur Child Adolesc Psychiatry 24, 1181–1191 (2015). https://doi.org/10.1007/s00787-014-0668-y

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  • DOI: https://doi.org/10.1007/s00787-014-0668-y

Keywords

  • Children
  • Adolescents
  • Antipsychotics
  • Prescribing trends
  • Community characteristics