title: Influence of socioeconomic status on antipsychotic prescriptions among youth in France.
abstract: Recent studies analysing the trends in antipsychotic (AP) prescriptions for children and adolescents have raised concerns regarding the influence of socioeconomic status. Previous findings have also shown variable prescription rates for first-generation (FG) and second-generation (SG) APs.
  
  
  
  Our objectives were to assess the proportion of patients from low-income families receiving APs and the most commonly prescribed APs in France. We conducted a descriptive analysis of AP drugs dispensed during a 1-year period (July 1, 2013-June 30, 2014) in a northwestern region of France with 941,857 subjects less than 18 years old. All data were extracted from an exhaustive, individual and anonymous social security database. We obtained each subject's socioeconomic status (by identifying their affiliation with a specific social security program) and also collected sociodemographic data, drug type, prescribing and dispensing dates and amount, and prescriber type (e.g., hospital physician, general practitioner, psychiatrist, paediatrician).
  
  
  
  There were two main novel findings. First, we found that the proportion of patients with AP prescriptions was nearly ten times higher in low-income families than in the general population: 35.9% of CMU-C patients compared to 3.7% in all of Pays de la Loire (X2= 7875.1, p < 0.001). Additionally, we found a higher rate of FGAP than SGAP prescriptions (65% vs. 57%).
  
  
  
  Our study suggests two types of AP misuse that could provide interesting targets for public healthcare interventions. First, our results strongly suggest an over-representation of patients from low-income families. Low-income families primarily resided in areas with low physician density and appeared to receive drugs to treat their conditions more frequently than other individuals. This increased prescription rate is a public health issue, potentially requiring political action. Second, the use of FGAPs did not adhere to the latest recommendations for drug use in this population, and this discrepancy should be addressed with informational campaigns targeted to medical practitioners.
authors.affiliation: Department of Child and Adolescent Psychiatry, University Hospital of Nantes, Nantes, France. olivier.bonnot@gmail.com.|Department of Child and Adolescent Psychiatry, University of Nantes, CHU de Nantes, 55 rue St Jacques, 44 000, Nantes, France. olivier.bonnot@gmail.com.
authors.forename: Olivier
authors.identifier: 0000-0003-0005-4765
authors.initials: O
authors.lastname: Bonnot
authors.affiliation: Department of Pharmacology, University Hospital of Nantes, Nantes, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Dufresne
authors.affiliation: Department of Child and Adolescent Psychiatry, University Hospital of Nantes, Nantes, France.|Medical Department, French National Health Insurance (DRSM), Nantes, France.
authors.forename: Paula
authors.initials: P
authors.lastname: Herrera
authors.affiliation: Grupo de Investigación en Neurociencias NeURos, Universidad del Rosario, Bogota, Colombia.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Michaud
authors.affiliation: Grupo de Investigación en Neurociencias NeURos, Universidad del Rosario, Bogota, Colombia.
authors.forename: Jacques
authors.initials: J
authors.lastname: Pivette
authors.affiliation: Grupo de Investigación en Neurociencias NeURos, Universidad del Rosario, Bogota, Colombia.
authors.forename: Anicet
authors.initials: A
authors.lastname: Chaslerie
authors.affiliation: Department of Psychiatry, University Hospital of Nantes, Nantes, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Sauvaget
authors.affiliation: Department of Pharmacology, University Hospital of Nantes, Nantes, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vigneau
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D011570:Psychiatry; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D012923:Social Class
chemical_list: D014150:Antipsychotic Agents