Risk of diabetes in children and adolescents exposed to antipsychotics

Washington D.C., September 2, 2014 – A study published in the September 2014 issue of the Journal of the American Academy of Child and Adolescent Psychiatry found that children and adolescents diagnosed with a psychiatric diagnosis had an increased risk of developing diabetes if they were exposed to antipsychotics.

Using data from the nationwide Danish registers, a group of researchers led by Dr. René Ernst Nielsen, Psychiatry, Aalborg University Hospital, Denmark, studied 48,299children and adolescents with psychiatric disorders to document the frequency and possible predictors of type II diabetes, defined by treatment with an oral antidiabetic drug.

The study found that the absolute risk of diabetes in psychiatrically ill youth exposed to antipsychotic medications was approximately 0.72% compared to 0.27% in those not exposed to antipsychotics. Especially female sex and antipsychotic drug exposure increased the risk of developing type II diabetes, while type of psychiatric diagnosis was not related to diabetes development.

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

Dr. Nielsen said of the study, "The use of antipsychotic drug treatment can be necessary for some of the psychiatric disorders diagnosed in children and adolescents. This study underscores the importance of following the current guidelines that antipsychotics should only be used in children and adolescents when other evidence-based and safer treatment options have been exhausted."

The study was a longitudinal register linkage case control study of type II diabetes, defined as prescription of an oral antidiabetic drug, in all child and adolescent hospital-based psychiatric patients diagnosed in Denmark from January 1st 1999 and June 30st 2010. The time period was defined to allow full retrieval of data from all relevant registers.

The article, "Risk of Diabetes in Children and Adolescents Exposed to Antipsychotics: A Nationwide 12-Year Case-Control Study" by René Ernst Nielsen, MD, PhD; Mathilde Frahm Laursen, Ditte Lammers Vernal, Charlotte Bisgaard, Helle Jakobsen, Hans-Christoph Steinhausen, Christoph U. Correll appears in the Journal of the American Academy of Child and Adolescent Psychiatry, Volume 53, Issue 9 (September 2014), published by Elsevier.

Notes for Editors

Full text of the article is available to credentialed journalists 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 press corrected proofs online at http://jaacap.org/inpress. Articles cannot be publicized as in press accepted manuscripts. Contents of the publication should not be released to or by the media or government agencies prior to the embargo date.

About JAACAP

Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

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