NEW YORK (Reuters Health) - US children are substantially more likely to be prescribed drugs for mental conditions than their peers in the Netherlands and Germany, new research shows.

The findings raise questions about treatment of mental health issues among US children that should be answered, Dr. Julie M. Zito of the University of Maryland in Baltimore, the study's lead author, told Reuters Health.
"We don't know if the big numbers are good and the small numbers are bad or the reverse," she said in an interview.
What's more, Zito added, data on the safety and effectiveness of these drugs in kids remains sparse. "We have almost no information on outcomes in children in the community."
More and more children are taking these so-called psychotropic medications, with the most common being stimulants, antidepressants, and antipsychotics, Zito and her team write in the online journal Child and Adolescent Psychiatry and Mental Health. They looked at the rates of use of these medications in children in the three countries to better understand the influence of regulations, clinical practices and social factors.
The researchers reviewed 2000 data on 110,944 people aged 0 to 19 in the Netherlands, 356,520 young people in Germany, and 127,157 in the US. All had health insurance.
US children were the most likely to be medicated, with 6.7% taking a prescription psychotropic, compared to 2.9% of Dutch youngsters and 2% of Germans.
American kids were also more likely to be on multiple drugs; 19.2% of those who were taking the medications were taking two or more, compared to 8.5% of young people in the Netherlands and 5.9% of those in Germany.
Overall, the researchers found, young people in the US were at least three times as likely as those in Europe to be prescribed antidepressants or stimulant drugs and about twice as likely to be taking antipsychotic drugs.
The reasons behind the national differences remain unclear, Zito notes. "We think culture plays something of a role. Certainly American physicians have long been known to be more intensive in treatment protocols than Europeans," she said.
However, Zito added, psychiatric training and diagnostic practices in the US are very similar to those in Western Europe.
More research is needed, she said, to clarify guidelines for treatment of children taking psychotropic medications, to ensure that they are getting comprehensive care. If children's mental health problems are symptomatic of larger social issues in the US, Zito added, medication alone may not be the best way to deal with them.
SOURCE: Child and Adolescent Psychiatry and Mental Health, online September 24, 2008.

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