智能障礙兒童與青少年使用抗精神疾病用藥之趨勢分析

Trends in the use of Psychotropic Drugs among Children and Adolescents with Intellectual Disability in Taiwan

目的：精神疾病是智能障礙者最常合併症之一，需透過長期藥物來穩定治療，本研究目的在利用健保資料庫之數據，分析智能障礙兒童與青少年使用抗精神疾病用藥之趨勢。方法：使用1997-2007 年全民健康保險資料庫，將門診處方及治療明細檔ICD-9編碼為317-318 且年齡為18 歲（含）以下之個案定義為本研究之樣本，探討使用抗精神系統疾病用藥之情形與變化趨勢。結果：整體抗精神系統疾病用藥使用盛行率自1997 年14.76%逐年增加為2007 年的22.50%，11 年間上升52.44%（p=0.0036）。除投保地區外，性別、年齡、障礙等級與部分負擔等變項之盛行率變化，均呈現增加趨勢且達統計學上之差異。抗精神病藥物、抗憂鬱劑與精神興奮藥之使用率顯著逐年增加。結論：結果顯示智能障礙兒童與青少年抗精神系統疾病藥使用之程逐年上升趨勢，性別、年齡與有無重大傷病註記為使用抗精神系統疾病藥之影響因子。本研究同時發現個案有使用二類（含）以上抗精神系統疾病藥之情形，建議往後可以針對長期使用二類（含）以上抗精神系統疾病藥對智能障礙者身體健康之影響進行研究。

This study aims to examine trends in outpatient psychotropic drug use among children and adolescents with intellectual disabilities in Taiwan. The NHI outpatient medication records between January 1, 1997 and December 31, 2007 for people age 18 and younger with intellectual disabilities were analyzed to observe the percent change, prevalence and prescription trends in psychotropic drugs. This study found the overall prevalence of psychotropic medication increased from14.76% to 22.50%during the study period The prescription rates of antipsychotics increased from4.33% to 7.04% (p<0.001); antidepressants increased from1.20% to 3.50%(p<0.001) and psychostimulants increased from 2.66 % to 10.76%(p<0.001). Gender, age and catastrophic disease were the major factors affecting the use of psychotropic medication. This study also found some subjects took more than one kind psychotropic medication. Further research is needed to explore the health effect of long term usage of multiple psychotropic medication.