Risk of diabetes in children and adolescents exposed to antipsychotics: a nationwide 12-year case-control study

Reports new study in Journalof the American Academy of Child and Adolescent Psychiatry

Washington D.C September 2, 2014

A studypublished in the September 2014 issue of the Journal of the American Academyof Child and Adolescent Psychiatry found that children and adolescentsdiagnosed with a psychiatric diagnosis had an increased risk of developingdiabetes if they were exposed to antipsychotics.

Usingdata from the nationwide Danish registers, a group of researchers led by Dr. René Ernst Nielsen,Psychiatry, Aalborg University Hospital, Denmark, studied 48,299children andadolescents with psychiatric disorders to document the frequency and possiblepredictors of type II diabetes, defined by treatment with an oral antidiabeticdrug.

The studyfound that the absolute risk of diabetes in psychiatrically ill youth exposedto antipsychotic medications was approximately 0.72% compared to 0.27% in thosenot exposed to antipsychotics. Especially female sex and antipsychotic drugexposure increased the risk of developing type II diabetes, while type ofpsychiatric diagnosis was not related to diabetes development.

Taken together, these data raise further concern about thefrequent use of antipsychotics for non-psychotic disorders and off-label conditions,such as disruptive behavior disorders, which should first be treated withnon-pharmacologic management options. Moreover, regular cardiometabolicmonitoring, including fasting glucose and hemoglobin A1C testing should beintegral part of antipsychotic prescribing to children and adolescents.

Dr. Nielsen said of the study, "The use of antipsychoticdrug treatment can be necessary for some of the psychiatric disorders diagnosedin children and adolescents. This study underscores the importance of followingthe current guidelines that antipsychotics should only be used in children andadolescents when other evidence-based and safer treatment options have beenexhausted."

The study was a longitudinal register linkage case controlstudy of type II diabetes, defined as prescription of an oral antidiabeticdrug, in all child and adolescent hospital-based psychiatric patients diagnosedin Denmark from January1st 1999 and June 30st 2010. The time period was definedto allow full retrieval of data from all relevant registers.

Thearticle, "Risk of Diabetes in Children and Adolescents Exposed toAntipsychotics: A Nationwide 12-Year Case-Control Study" by René Ernst Nielsen, MD, PhD; Mathilde Frahm Laursen,Ditte Lammers Vernal, Charlotte Bisgaard, Helle Jakobsen, Hans-ChristophSteinhausen, Christoph U. Correll (http://www.sciencedirect.com/science/article/pii/S0890856714004055)appears in the Journal of the American Academy of Child and AdolescentPsychiatry, Volume 53, Issue 9 (September 2014), published by Elsevier.


Notesfor editors
Full text of the article is available to credentialedjournalists upon request; contact Mary Billingsley at +1 202 587 9672 or mbillingsley@jaacap.org.Journalists wishing to interview the authors may contact Dr.René Ernst Nielsen at ren@rn.dk.

 All articles published in JAACAP are embargoed until the day they are published as in presscorrected proofs online at http://jaacap.org/inpress.Articles cannot be publicized as in press accepted manuscripts. Contents of thepublication should not be released to or by the media or government agencies priorto the embargo date.

 Journal of the American Academy ofChild and Adolescent Psychiatry (JAACAP) is the official publication ofthe American Academy of Child and Adolescent Psychiatry. JAACAP is theleading journal focusing exclusively on today's psychiatric research andtreatment of the child and adolescent. Published twelve times per year, eachissue is committed to its mission of advancing the science of pediatric mentalhealth and promoting the care of youth and their families.

The journal's purpose is to advance research, clinical practice, andtheory in child and adolescent psychiatry. It is interested in manuscripts fromdiverse viewpoints, including genetic, epidemiological, neurobiological,cognitive, behavioral, psychodynamic, social, cultural, and economic. Studiesof diagnostic reliability and validity, psychotherapeutic andpsychopharmacological treatment efficacy, and mental health serviceseffectiveness are encouraged. The journal also seeks to promote the well-beingof children and families by publishing scholarly papers on such subjects ashealth policy, legislation, advocacy, culture and society, and serviceprovision as they pertain to the mental health of children and families.

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