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

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


Vicky P. Taxiarchi

Matthias Pierce


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.

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
Keywords Antidepressants, Prescriptions, Children and young people (CYP), Primary care, Secondary care


Taxiarchi VoR (704 Kb)

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