Children and adolescents with type 1 diabetes are at an elevated risk for psychiatric disorders, but treatment with psychotropic medications can cause adverse effects in this patient population. A new study has found that the prevalence of youth receiving these medications increased dramatically in Sweden from 2006 to 2019. The findings were published this week in JAMA Network Open.
“Various antipsychotics, mood stabilizers, and antidepressants have been associated with detrimental metabolic outcomes, including weight gain, hyperlipidemia, and insulin resistance,” wrote Shengxin Liu, M.Sc., and Tyra Lagerberg, Ph.D., of the Karolinska Institutet in Sweden and colleagues. “For children and adolescents with [type 1 diabetes], who already face an increased risk of metabolic complications and gastrointestinal symptoms, these adverse effects may exacerbate their health outcomes.”
Liu, Lagerberg, and colleagues used national Swedish registries to obtain data on all children (birth to 11 years) and adolescents (aged 12 to 17) who resided in Sweden at some point from 2006 to 2019. The National Patient Register provided information on patients diagnosed with type 1 diabetes and psychiatric disorders (such as depression, psychotic disorders, or personality disorders). The Prescribed Drug Register provided information on the medications dispensed to the youth. The authors specifically focused their analysis on first- and second-generation antipsychotics, antidepressants, anxiolytics, hypnotics, mood stabilizers, and medication for attention-deficit/hyperactivity disorder (ADHD).
Among 3.7 million children and adolescents, 13,200 had type 1 diabetes, 1,866 (14.1%) of whom were dispensed psychotropic medications during the study period. Other findings included the following:
- The prevalence of children with type 1 diabetes receiving psychotropic medications increased from 0.85% in 2006 to 3.84% in 2019.
- The prevalence of adolescents with type 1 diabetes receiving psychotropic medications increased from 2.72% in 2006 to 13.54% in 2019.
- Youth with type 1 diabetes consistently received psychotropic medications more than their peers without type 1 diabetes.
- The most commonly dispensed medications included hypnotics, ADHD medications, anxiolytics, and antidepressants.
- Psychiatric care was the primary source for prescriptions for psychotropic medications for youth with type 1 diabetes.
- Up to 50.1% of treatments with psychotropic medications lasted more than a year.
“The findings from our study emphasize the importance of integrating pediatric diabetes care and mental health professionals when managing children and adolescents with [type 1 diabetes],” the authors wrote. “This collaborative effort is essential not only for the early detection and screening of patients’ psychological needs but also for the diligent monitoring of psychotropic medication usage and patient outcomes.”
For related information, see the Psychiatric Services article “Adherence to Recommended Metabolic Monitoring of Children and Adolescents Taking Second-Generation Antipsychotics.”
(Image: iStock/Irina_Geo)
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