Decisions about Drug Treatment in Children

Abstract

This article investigates factors that influence child psychiatrists' decisions about drug treatment of children with psychiatric disturbances. Brief vignettes provide descriptions of nine hypothetical patients representing different clinical syndromes. Twenty-five child psychiatrists provided preference ranking for 13 commonly used psychotropic drugs with regard to each type of patient. The results suggest three distinct child treatment populations for which different classes of drugs are preferred: thinking disorders, depression, and attention deficit disorder. Within these major populations, choice among the antipsychotic medications tended to be influenced by the presence and degree of concomitant depression. While many psychiatrists were not apt to treat depressed children with antidepressants, these drugs were relatively preferred in the treatment of withdrawn or retarded depressions. For a substantial portion of the child psychiatrists, choice of drugs for the treatment of attention deficit disorder appeared to be influenced by age of the patient. The child psychiatrists differed greatly in overall endorsement of drug use across all types of patients. Psychotic thought disorders, followed by attention deficit disorders, were the cases in which medication was most often preferred.