Psychopharmacological Prescriptions in Children and Adolescents in Germany.

It is estimated that, worldwide, 10–20% of all children and adolescents are affected by mental health problems (1). A meta-analysis published in 2004 put the prevalence of emotional and behavioral disorders in Germany at 18% (2). According to recent data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland) conducted by the Robert Koch Institute, there is no evidence to suggest that the frequency of psychological disorders rose between 2003–2006 and 2009–2012 (3, 4). Nevertheless, psychopharmacological prescriptions in children and adolescents rose both in Germany (5– 8) and internationally (9– 15). While the number of methylphenidate prescriptions between the early 1990s and today has peaked and now appears to be dropping (16, 17), the prescription of antipsychotic drugs for children and adolescents appears to be in the early stages of a comparable trend (6, 15). Whereas the majority of previous studies have focused on trends in prescription prevalences, i.e., the number of children and adolescents receiving at least one prescription in the relevant year, investigations of new prescriptions (incidences) are lacking. A comparison of these two figures enables a nuanced interpretation of prescription practices. In addition, studies investigating trends in individual groups of psychotropic drugs over time in Germany, are few, and mostly older (5– 8, 18– 20). This study therefore provides the first detailed overview for Germany of trends in prescriptions and new prescriptions of psychotropic drugs (psycholeptics and psychoanaleptics) in general, and of trends in the subgroups of antipsychotics, anxiolytics, hypnotics, as well as sedatives, antidepressants, and stimulants, over the 9 years between 2004 and 2012. The study also analyzed trends among physician groups issuing initial prescriptions to new recipients, as well as previous treatment with other psychotropic drugs. To this end, nationwide data from statutory health insurance companies (AOK, Allgemeine Ortskrankenkasse, and TK, Techniker Krankenkasse), covering approximately a third of all children and adolescents in Germany, were analyzed (21).