Fetal Alcohol Spectrum Draws Range of Diagnoses


SAN DIEGO — Children with fetal alcohol spectrum disorders receive a wide variety of psychiatric diagnoses and medications, Julia Murray, M.D., reported in a poster presentation at the American Psychiatric Association's Institute on Psychiatric Services.

“Out in the community, people are trying to address the needs of these kids, but it looks as if [they] are being given all kinds of diagnoses. They have a full spectrum of psychiatric symptoms, and they're receiving a wide range of diagnoses and psychotropic medications,” said Dr. Murray, a psychiatrist at Odessa Brown Children's Clinic, Seattle.

As part of a study funded by the Centers for Disease Control and Prevention, Dr. Murray and associates reviewed medical charts of 50 children with fetal alcohol spectrum disorders or alcohol-related neurodevelopmental disorders and behavioral problems who were enrolled in community-based therapeutic programs. The records covered about 18 months.

“It's been reported that kids with fetal alcohol spectrum disorders do have depression, bipolar syndromes, and psychosis syndromes, but there has been very little quantitative and qualitative description,” Dr. Murray said. “The literature primarily addresses an [attention-deficit hyperactivity disorder]-type behavioral syndrome and the use of stimulants. There's not much about treatment for any other diagnoses.”

The mean baseline age of participants was about 9 years. Of 50 children, 76% had received psychiatric diagnoses. Overall, 23 psychiatric conditions were found, including attention-deficit hyperactivity disorder (74%), learning disorders (26%), cognitive disorders (26%), disruptive behavior disorders (21%), and anxiety disorders (18%).

More than half (56%) had been prescribed a mean of 2.23 simultaneous medications, ranging from stimulants to atypical antipsychotics. Primary care clinicians were the most frequent prescribers (50%), followed by psychiatrists (42%), and both (8%). The study was limited because the investigators “didn't try to verify the diagnoses or look at the efficacy of the medications that we used,” Dr. Murray said.

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