Abstract

Background: Mental disorders are common among children and adolescents, worldwide. However, little is known about the patterns of psychiatric diagnoses in Saudi Arabia in general. Moreover, it is crucial to examine the prescribing patterns of psychotropic medications and polypharmacy among children and adolescents as the benefits versus risks are not clear in this population. This study aimed to evaluate the patterns of psychiatric diagnoses as well as prescribing patterns of psychotropic medications and polypharmacy among children and adolescents in the Jazan region of Saudi Arabia.
Methods: A retrospective cross-sectional study design was conducted with a sample of children and adolescents (N=647) who attended the outpatient clinics in the psychiatric hospital in the Jazan region, Southwest of Saudi Arabia. Age, gender and clinical outcomes were retrieved from the electronic health records of the sample. Outcome Measures included patterns of psychiatric diagnoses and prescribing patterns of psychotropic medications and polypharmacy (>=2 psychotropic medications). Logistic regression models were conducted to examine the relationships between the explanatory variables and the following: polypharmacy, antidepressants, antipsychotics and stimulants prescriptions.
Results: The most prevalent psychiatric diagnosis was attention-deficit hyperactivity disorder (31.5%) followed by autism and pervasive developmental disorders (27.6%) and mental retardation (24%). The most prescribed psychotropic classes were antipsychotics and stimulants. Approximately, a quarter of the children and adolescents were given psychotropic polypharmacy. A higher percentage of adolescents were given polypharmacy than children (31.5% vs 18.2%). In the adjusted analyses, adolescents were more likely to receive psychotropic polypharmacy, antidepressants and stimulants than children. Nevertheless, adolescents were less likely than children to be given antipsychotics.
Conclusions: Psychotropic polypharmacy rates in the Jazan region are concerning, especially among adolescents. Healthcare professionals should closely monitor children and adolescents with psychotropic polypharmacy to minimize the risk of drug-drug and/or drug-disease interactions.

Key words: psychotropic polypharmacy, drug utilization, psychiatric diagnoses, children, adolescents