Ethnic differences in maintenance antipsychotic prescription among adolescents with bipolar disorder.
OBJECTIVE
The aim of this study was to compare the longitudinal use of psychotropic medications in African-American and Caucasian adolescents with a diagnosis of bipolar disorder following their first psychiatric hospitalization.


METHODS
Age- and gender-matched African-American (n=16) and Caucasian (n=16) adolescents, between the ages of 12 and 18 years and meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for bipolar I disorder, manic or mixed, were evaluated over a period of 1 year following their first psychiatric hospitalization for a mood episode. Medication prescription and adherence during follow-up were compared between ethnic groups.


RESULTS
African-American adolescents received antipsychotic prescription for a significantly greater percentage of time during follow-up than Caucasian adolescents, after adjusting for rate of psychotic features (79% versus 40%; p=0.05). African-American and Caucasian patients received mood stabilizer/anticonvulsant prescription for similar percentages of time during follow-up. African-American and Caucasian adolescents exhibited similar rates of full adherence to antipsychotics, mood stabilizers/anticonvulsants, and all psychotropic medications.


CONCLUSIONS
African-American adolescents were prescribed atypical antipsychotic medications for longer periods of time than Caucasian adolescents, but reasons for this finding were unclear. Additional research efforts in adolescent bipolar disorder are needed to explore factors associated with ethnic disparity in pharmacological treatment interventions.
Patel
Nick C
NC
Department of Psychiatry, University of Cincinnati, and the General Clinical Research Center and Mental Health Service Line, Cincinnati Veterans Affairs Medical Center, Ohio 45267-0004, USA. nick.patel@uc.edu
DelBello
Melissa P
MP
Keck
Paul E
PE
Strakowski
Stephen M
SM
D000293:Adolescent; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000208:ethnology; D044383:Black People / Q000523:psychology*; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008134:Long-Term Care; D008297:Male; D044465:White People / Q000523:psychology*; D001741:Black or African American
D014150:Antipsychotic Agents