Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar-Apr:45:32-39.
doi: 10.1016/j.genhosppsych.2016.12.004. Epub 2016 Dec 15.

Examining psychotropic medication use among youth in the U.S. by race/ethnicity and psychological impairment

Benjamin Lê Cook  1 , Nicholas J Carson  2 , E Nilay Kafali  3 , Anne Valentine  4 , Juan David Rueda  5 , Sarah Coe-Odess  6 , Susan Busch  7
Affiliations

Examining psychotropic medication use among youth in the U.S. by race/ethnicity and psychological impairment

Benjamin Lê Cook et al. Gen Hosp Psychiatry. 2017 Mar-Apr.

Abstract

Objective: Clinical practice guidelines underscore the need for careful evaluation of the risk-benefit ratio of psychotropic medications treating mental health disorders among youth. While it is well known that racial/ethnic disparities exist in psychotropic medication use, little is known about whether these differences are driven by over-prescribing among white youth, under-prescribing among minority youth, or both. To build evidence in this area, this study examined racial/ethnic differences in the prescription of psychotropic medications among youth with and without psychological impairment.

Methods: Secondary data on two-year medication use from the 2004-2011 Medical Expenditure Panel Surveys were analyzed. We capitalized on two-year panel data, creating variables that allow for differential sequencing of psychological impairment and medication prescription (e.g., impairment in year 1 or year 2, and a psychotropic medication fill in year 2). Statistical differences were determined using unadjusted rate comparisons and logistic regression models, after adjustment for socio-contextual and health status characteristics.

Results: Compared to Black and Latino youth with psychological impairment, White youth were more likely to be prescribed psychotropic medications when impaired. Among youth never having psychological impairment, White youth were also more likely to be prescribed medications compared to their racial/ethnic minority counterparts.

Conclusions: Differences in rates of medication use among youth with and without impairment suggest poor medication targeting across racial/ethnic groups. These results, combined with recent psychotropic medication risk warnings and concerns over increases in psychotropic medication use among youth, suggest that a continued emphasis on accurate targeting of prescribing patterns is needed across racial/ethnic groups.

Keywords: Psychopharmacology; Racial/ethnic disparities; Youth.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest and disclosures

All authors have completed the ICMJE uniform disclosure form and declare no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, and no other relationships or activities that could appear to have influenced the submitted work.

This research has been approved by the Cambridge Health Alliance Institutional Review Board.

I, Benjamin Cook, hereby affirm that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

Figures

Fig. 1.
Fig. 1.
Decomposition of disparities in youth psychotropic drug use by indicated use, non-indicated use, and underuse.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Merikangas KR, He JP, Rapoport J, Vitiello B, Olfson M. Medication use in US youth with mental disorders medication use in US youth with mental disorders. JAMA Pediatr 2013;167(2):141–8. - PubMed
    1. Zito JM, Burcu M, Ibe A, Safer DJ, Magder LS. Antipsychotic use by medicaid-insured youths: impact of eligibility and psychiatric diagnosis across a decade. Psychiatr Serv 2013;64(3):223–9. 10.1176/appi.ps.201200081. - DOI - PubMed
    1. Matone M, Localio R, Huang YS, dosReis S, Feudtner C, Rubin D. The relationship between mental health diagnosis and treatment with second-generation antipsychotics over time: a national study of U.S. Medicaid-enrolled children. Health Serv Res 2012;47(5):1836–60. 10.1111/j.1475-6773.2012.01461.x. - DOI - PMC - PubMed
    1. Zuvekas SH, Vitiello B. Stimulant medication use in children: a 12-year perspective. Am J Psychiatry 2012;169(2):160–6. - PMC - PubMed
    1. Olfson M, Druss BG, Marcus SC. Trends in mental health care among children and adolescents. N Engl J Med 2015;372(21):2029–38. 10.1056/NEJMsa1413512. - DOI - PubMed

MeSH terms

Substances