Psychiatric Diagnoses and Medication Use in Children Insured by Medicaid

Bottom Line: Young children insured by Medicaid with a psychiatric diagnosis had early and prolonged exposure to psychotropic medications.

Why The Research Is Interesting: Treated psychiatric diagnoses and the use of psychotropic medications has increased in the pediatric population amid concerns of off-label prescription of medication use (not approved by the U.S. Food and Drug Administration). The short- and long-term effects of early exposure to complex combinations of medications are unknown.

Who and When: Medicaid claims data for 35,244 children born in a mid-Atlantic state in 2007 and followed up through 2014

What (Study Measures): Mental health treatments from birth through age 7 (exposures); cumulative incidence (frequency over time) of a first psychiatric diagnosis and psychotropic medication use from birth through age 7 and duration of medication use (outcomes)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control for all other factors that could explain the study findings.

Authors: Dinci Pennap, M.P.H., and Julie Zito, Ph.D., of the University of Maryland, Baltimore, and coauthors

Results: 

Study Limitations: Medicaid data from one state; study captured medication dispensed not consumed; but longitudinal (over time) analysis of  one group of children assessed across eight years permitted a cumulative assessment of outcomes

Study Conclusions: The study highlights the need for safety and outcomes research after initiating psychotropic medication use in very young populations of children, particularly for health outcomes.

Related Material: An editor article review podcast with Aaron E. Carroll, M.D., M.S., JAMA Pediatrics digital media editor, also is available on the For The Media website. The transcript is available here.

 

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jamapediatrics.2018.0240)