Substantially more children receiving antidepressants see a specialist than reported by Jack et al.

Taxiarchi, Vicky P.; Chew-Graham, Carolyn A.; Pierce, Matthias

Abstract

We would like to draw attention to evidence of substantial bias in the article published in this journal by Jack et al. (BMC Med 18:1-12, 2020). They provide an analysis of antidepressant prescribing to children and young people (CYP; ages 5 to 17) in primary care in England and reported that only 24.7% of CYP prescribed SSRIs for the first time were seen by a child and adolescent psychiatrist—contrary to national guidelines. We believe that their analysis is based on incomplete data that misses a large proportion of specialist mental health contacts. This is because the dataset Jack et al. used to capture specialist mental health contact—The Hospital Episode Statistics (HES) dataset—has poor coverage, as most CYP mental health services do not submit data. We demonstrate the level of underreporting with an analysis of events in a large primary care dataset where there has been a record of definite contact with CYP mental health services. We report that as many as three quarters of specialist CYP contacts with mental health specialists are missed in the HES dataset, indicating that the figure presented by Jack et al. is substantially wrong.

Citation

Taxiarchi, V. P., Chew-Graham, C. A., & Pierce, M. (in press). Substantially more children receiving antidepressants see a specialist than reported by Jack et al. BMC Medicine, 21(1), Article 345. https://doi.org/10.1186/s12916-023-03043-x

• Journal Article Type: Article
• Acceptance Date: Aug 21, 2023
• Online Publication Date: Sep 11, 2023
• Deposit Date: Sep 20, 2023
• Publicly Available Date: Sep 20, 2023
• Journal: BMC Medicine
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 1
• Article Number: 345
• DOI: https://doi.org/10.1186/s12916-023-03043-x
• Keywords: Antidepressants, Prescriptions, Children and young people (CYP), Primary care, Secondary care