American children are approximately three times more likely to be prescribed psychotropic medication than children in Europe. A new study claims that the differences may be accounted for by regulatory practices and cultural beliefs about the role of medication in emotional and behavioural problems.
Julie Zito led a team of researchers from the USA, Germany and the Netherlands who investigated prescription levels in the three countries. She said, "Antidepressant and stimulant prevalence were three or more times greater in the US than in the Netherlands and Germany, while antipsychotic prevalence was 1.5 to 2.2 times greater".
The use of antidepressants, like Prozac, and stimulants, like Ritalin, in children has been the subject of a great deal of controversy and this study quantifies the differences in practice between the US and Western Europe. The authors claim that the differences may be partly due to different diagnostic classification systems, "The US trend of increasing bipolar diagnosis in children and adolescents does not reflect European practice".
The authors also mention government cost restrictions in Europe, the larger number of child psychiatrists per capita in the US and the use of two or more different psychotropic drugs in a single year in US children as possible explanations.
Zito concludes that, "Direct to consumer drug advertising, which is common in the US, is also likely to account for some of the differences. The increased use of medication in the US also reflects the individualist and activist therapeutic mentality of US medical culture".
- Julie M Zito, Daniel J Safer, Lolkje TW de Jong-van den Berg, Katrin Janhsen, Joerg M Fegert, James F Gardner, Gerd Glaeske and Satish C Valluri. A three-country comparison of psychotropic medication prevalence in youth. Child and Adolescent Psychiatry and Mental Health, (in press)
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