One-fifth of Medicaid kids receive mental health diagnoses

 

Twenty percent of children insured by Medicaid received a psychiatric diagnosis before 8 years of age, according to data from more than 35,000 Medicaid-insured children in a mid-Atlantic state.

Previous cross-sectional studies have addressed trends in psychiatric treatment of children. “However, little is known about the longitudinal patterns of pediatric use of psychiatric services,” wrote Dinci Pennap, MPH, of the University of Maryland, Baltimore, and her colleagues.

juststock/gettyimages

In a review published in Pediatrics, the researchers used ICD-9-CM codes in 2007 to examine patterns of psychiatric diagnosis and medication use among 35,244 children born in a mid-Atlantic state.

By the age of 8 years, 20% of the children had received a psychiatric diagnosis; 58% of these diagnoses were behavioral. The most common psychiatric diagnoses were ADHD (44%) and learning disorder (32%).

In addition, 10% (2,196) of children had received psychotropic medications. Of those receiving psychotropic medications, 81% received a single medication, 16% received two medications, and 4% received three medications for 60 days or more, the researchers said. Girls were significantly more likely than boys to be diagnosed with adjustment disorder (22% vs. 15%, respectively) or anxiety disorder (7% vs. 4%, respectively). Boys were significantly more likely than girls to be diagnosed with ADHD (30% vs. 22%).

By age 8 years, 75% of children prescribed medication had received a stimulant, 32% had received an alpha-agonist, and 20% had received an anxiolytic or hypnotic medication, the researchers said.

 

The study findings were limited by several factors, including the use of clinician-reported diagnoses rather than research-identified diagnoses and the possible lack of generalizability to Medicaid populations in other regions or to privately insured children, the researchers noted. However, the results captured long-term psychotropic use and “highlight the need for safety and outcomes research, particularly for health outcomes such as metabolic imbalance, weight gain, and sleep disturbances after initiation of psychotropic medication for very young children.”

Dr. Pennap had no financial conflicts to disclose. One of the study coauthors disclosed research grants from the National Institutes of Health.

SOURCE: Pennap D et al. JAMA Pediatr. 2018. doi: 10.1001/jamapediatrics.2018.0240.

 

Twenty percent of children insured by Medicaid received a psychiatric diagnosis before 8 years of age, according to data from more than 35,000 Medicaid-insured children in a mid-Atlantic state.

Previous cross-sectional studies have addressed trends in psychiatric treatment of children. “However, little is known about the longitudinal patterns of pediatric use of psychiatric services,” wrote Dinci Pennap, MPH, of the University of Maryland, Baltimore, and her colleagues.

juststock/gettyimages

In a review published in Pediatrics, the researchers used ICD-9-CM codes in 2007 to examine patterns of psychiatric diagnosis and medication use among 35,244 children born in a mid-Atlantic state.

By the age of 8 years, 20% of the children had received a psychiatric diagnosis; 58% of these diagnoses were behavioral. The most common psychiatric diagnoses were ADHD (44%) and learning disorder (32%).

In addition, 10% (2,196) of children had received psychotropic medications. Of those receiving psychotropic medications, 81% received a single medication, 16% received two medications, and 4% received three medications for 60 days or more, the researchers said. Girls were significantly more likely than boys to be diagnosed with adjustment disorder (22% vs. 15%, respectively) or anxiety disorder (7% vs. 4%, respectively). Boys were significantly more likely than girls to be diagnosed with ADHD (30% vs. 22%).

By age 8 years, 75% of children prescribed medication had received a stimulant, 32% had received an alpha-agonist, and 20% had received an anxiolytic or hypnotic medication, the researchers said.

 

The study findings were limited by several factors, including the use of clinician-reported diagnoses rather than research-identified diagnoses and the possible lack of generalizability to Medicaid populations in other regions or to privately insured children, the researchers noted. However, the results captured long-term psychotropic use and “highlight the need for safety and outcomes research, particularly for health outcomes such as metabolic imbalance, weight gain, and sleep disturbances after initiation of psychotropic medication for very young children.”

Dr. Pennap had no financial conflicts to disclose. One of the study coauthors disclosed research grants from the National Institutes of Health.

SOURCE: Pennap D et al. JAMA Pediatr. 2018. doi: 10.1001/jamapediatrics.2018.0240.

 

Twenty percent of children insured by Medicaid received a psychiatric diagnosis before 8 years of age, according to data from more than 35,000 Medicaid-insured children in a mid-Atlantic state.

Previous cross-sectional studies have addressed trends in psychiatric treatment of children. “However, little is known about the longitudinal patterns of pediatric use of psychiatric services,” wrote Dinci Pennap, MPH, of the University of Maryland, Baltimore, and her colleagues.

juststock/gettyimages

In a review published in Pediatrics, the researchers used ICD-9-CM codes in 2007 to examine patterns of psychiatric diagnosis and medication use among 35,244 children born in a mid-Atlantic state.

By the age of 8 years, 20% of the children had received a psychiatric diagnosis; 58% of these diagnoses were behavioral. The most common psychiatric diagnoses were ADHD (44%) and learning disorder (32%).

In addition, 10% (2,196) of children had received psychotropic medications. Of those receiving psychotropic medications, 81% received a single medication, 16% received two medications, and 4% received three medications for 60 days or more, the researchers said. Girls were significantly more likely than boys to be diagnosed with adjustment disorder (22% vs. 15%, respectively) or anxiety disorder (7% vs. 4%, respectively). Boys were significantly more likely than girls to be diagnosed with ADHD (30% vs. 22%).

By age 8 years, 75% of children prescribed medication had received a stimulant, 32% had received an alpha-agonist, and 20% had received an anxiolytic or hypnotic medication, the researchers said.

 

The study findings were limited by several factors, including the use of clinician-reported diagnoses rather than research-identified diagnoses and the possible lack of generalizability to Medicaid populations in other regions or to privately insured children, the researchers noted. However, the results captured long-term psychotropic use and “highlight the need for safety and outcomes research, particularly for health outcomes such as metabolic imbalance, weight gain, and sleep disturbances after initiation of psychotropic medication for very young children.”

Dr. Pennap had no financial conflicts to disclose. One of the study coauthors disclosed research grants from the National Institutes of Health.

SOURCE: Pennap D et al. JAMA Pediatr. 2018. doi: 10.1001/jamapediatrics.2018.0240.