Nursing ETDs

Publication Date

2-13-2014

Abstract

Children and adolescents with serious emotional disturbance (SED) who take atypical antipsychotics (AAs) gain significant amounts of weight. The purpose of this retrospective chart review study was to determine if type of AA, diagnosis, ethnicity/race, age, gender or months in treatment contribute to BMI z change score (weight gain). The sample was 110 children with SED who took AAs for 1-36 months, M age=10.5 years (SD=3.4, range 5-17), 67% male, 53% Hispanic or Latino. The average weight gain in the study was 22 pounds (0.33 BMI z change score). The percent of children classifed as overwieght or obese increased from 14% and 26% to 21% and 34%, respectively. Children on olanzapine, risperidone and quetiapine gained significantly more weight than children on aripiprazole or ziprasidone [t(106) = 1.16; p = .01; d=.23)]. Results of the hiearchical multiple regression (HMR) showed an interacton between type of AA and months in treatment. Months in treatment, the combined AA variables of olanzapine/quetiapine and aripiprazole/ziprasidone (with risperidone as the reference category), and the interactions terms for these variables together signficantly explained 14% of the explained variance of the BMI z change score [F (5, 103) = 3.40, p < .01). Distinct patterns of weight gain were revealed for each type of AA. The longer the child was on olanzapine, quetiapine, aripiprazole and ziprasidone, the more weight they gained. In contrast, children on risperidone lost weight over time [ b = -.03, SE(b) = .01, p < .001). Diagnosis, ethnicity, age, and gender did not significantly contribute to BMI z change score. In conclusion, examining these demographic and treatment factors shed light on the unknown interaction between type of AA and pattern of weight gain over months in treatment and could support the development of time specific interventions to slow or halt weight gain.

Degree Name

Nursing

Level of Degree

Doctoral

Department Name

College of Nursing

First Advisor

Tigges, Beth

First Committee Member (Chair)

Albers, Leah

Second Committee Member

Lobo, Marie

Third Committee Member

Moriarta, Marcia

Keywords

Children, Mental Illness, Weight Gain, Atypical Antipsychotics

Language

English

Document Type

Dissertation

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