Burden of psychiatric disorders in the pediatric population

In order to estimate the burden of mental disorders in a representative Italian pediatric population, an epidemiological study was performed using three administrative databases: a drug prescription, a hospital discharge form, and an outpatient ambulatory visit database. The population target was 1,616,268 children and adolescents under 18 years living in the Lombardy Region, Italy. A youth was defined as a case if during 2008 he/she received at least. one psychotropic drug prescription or was hospitalized for a psychiatric disorder (International Classification of Disease codes 290-319), or attended a child neuropsychiatric outpatient unit for a visit and/or a psychological intervention or rehabilitation at least once. Epileptic children were excluded. In all, 63,550 youths (39.3 per 1000; 95%CI 39.1-39.7 parts per thousand) were identified as users of health care resources for a putative mental disorder. The prevalence was higher in boys than in girls (47.0 parts per thousand versus 31.3 parts per thousand) and the highest value was recorded in children 8 years old (60.2 parts per thousand). A total of 59,987 youths (37.1 parts per thousand) attended a child and adolescent neuropsychiatry service at Least once, 3605 (2.2 parts per thousand) were admitted to hospital, and 2761 (1.7 parts per thousand) received at least one psychotropic drug prescription, 57% of which did not attend a child neuropsychiatry service. In all, 14,741 youths (23.1% of users) had a disorder that required a high intensity of care (e.g. recurrent prescriptions for drugs and/or ambulatory care). The proportion of youths who received care for mental disorders in the Lombardy Region seems lower than in other countries. However, the fact that many children were prescribed psychotropic drugs without the supervision of a child psychiatrist is a reason for concern. (c) 2012 Elsevier B.V. and ECNP. All rights reserved.