title: The relationship between mental health diagnosis and treatment with second-generation antipsychotics over time: a national study of U.S. Medicaid-enrolled children.
abstract: OBJECTIVE
  To describe the relationship between mental health diagnosis and treatment with antipsychotics among U.S. Medicaid-enrolled children over time.
  
  
  METHODS
  Medicaid Analytic Extract (MAX) files for 50 states and the District of Columbia from 2002 to 2007.
  
  
  METHODS
  Repeated cross-sectional design. Using logistic regression, outcomes of mental health diagnosis and filled prescriptions for antipsychotics were standardized across demographic and service use characteristics and reported as probabilities across age groups over time.
  
  
  METHODS
  Center for Medicaid Services data extracted by means of age, ICD-9 codes, service use intensity, and National Drug Classification codes.
  
  
  RESULTS
  Antipsychotic use increased by 62 percent, reaching 354,000 youth by 2007 (2.4 percent). Although youth with bipolar disorder, schizophrenia, and autism proportionally were more likely to receive antipsychotics, youth with attention deficit hyperactivity disorder (ADHD) and those with three or more mental health diagnoses were the largest consumers of antipsychotics over time; by 2007, youth with ADHD accounted for 50 percent of total antipsychotic use; 1 in 7 antipsychotic users were youth with ADHD as their only diagnosis.
  
  
  CONCLUSIONS
  In the context of safety concerns, disproportionate antipsychotic use among youth with nonapproved indications illustrates the need for more generalized efficacy data in pediatric populations.
authors.affiliation: PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
authors.forename: Meredith
authors.initials: M
authors.lastname: Matone
authors.forename: Russell
authors.initials: R
authors.lastname: Localio
authors.forename: Yuan-Shung
authors.initials: YS
authors.lastname: Huang
authors.forename: Susan
authors.initials: S
authors.lastname: dosReis
authors.forename: Chris
authors.initials: C
authors.lastname: Feudtner
authors.forename: David
authors.initials: D
authors.lastname: Rubin
mesh_terms: D000293:Adolescent; D000367:Age Factors; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D001321:Autistic Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents