title: Prevalence of bipolar disorder diagnoses and psychotropic drug therapy among privately insured children and adolescents.
abstract: OBJECTIVE
  To estimate the treated prevalence of bipolar disorder in a privately insured population, describe the characteristics of children and adolescents receiving these diagnoses, and describe patterns of their psychotropic drug therapy.
  
  
  METHODS
  Retrospective, repeated cross-sectional study.
  
  
  METHODS
  MarketScan Commercial Claims and Encounters inpatient, outpatient, and pharmacy claims databases.
  
  
  METHODS
  A total of 22,360 children and adolescents (aged 0-17 yrs) with one inpatient or two or more outpatient claims for any bipolar spectrum disorder between January 1, 2005, and December 31, 2007.
  
  
  RESULTS
  Annual cross-sections were used to estimate the treated prevalence of bipolar disorder diagnoses, patient characteristics, and psychotropic drugs used 30 days after a child's latest recorded bipolar disorder diagnosis within each year. The annual treated prevalence of any bipolar spectrum disorder in this privately insured population was 0.24% in 2005 and 0.26% in 2006 and 2007. Approximately 25% of diagnoses were for children younger than 13 years. Approximately 30% of children had coexisting attention-deficit-hyperactivity disorder during the year. In each year, 35% of patients used no psychotropic drug therapy in the 30-day period after their most recent diagnosis. Twenty-five percent used one psychotropic drug, and 40% used two or more drugs. The most common drug regimens were antipsychotic or mood stabilizer (lithium or anticonvulsant) monotherapy and the combination of mood stabilizers and antipsychotics.
  
  
  CONCLUSIONS
  Drug therapy patterns suggest that children and adolescents with bipolar diagnoses receive complex treatment regimens, often involving multiple classes of psychotropic drugs. Research on treatment combinations, particularly antipsychotic and mood stabilizer combinations, should be prioritized to better understand the safety and effectiveness of commonly prescribed treatments.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA. dusetzina@hcp.med.harvard.edu
authors.forename: Stacie B
authors.initials: SB
authors.lastname: Dusetzina
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Gaynes
authors.forename: Joel F
authors.initials: JF
authors.lastname: Farley
authors.forename: Betsy
authors.initials: B
authors.lastname: Sleath
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hansen
mesh_terms: D000293:Adolescent; D018692:Antimanic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D007348:Insurance, Health; D008297:Male; D010045:Outpatients; D015995:Prevalence; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D011619:Psychotropic Drugs