National trends in psychotropic medication use in young children: 1994-2009
Vilawan Chirdkiatgumchai1, Hong Xiao, Bridget K Fredstrom
1Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Mail Location 4002, Cincinnati, OH 45229. tanya.froehlich@cchmc.org.
Insights
Psychotropic medication use in very young children peaked in 2002-2005, with higher rates observed in boys, white children, and those without private insurance. Usage stabilized in later years, warranting further investigation into these trends.
Area of Science:
- Pediatric medicine
- Psychopharmacology
- Public health
Background:
- Psychotropic medication use in preschool-aged children has been a growing concern.
- Understanding national trends and disparities is crucial for appropriate clinical practice.
Purpose of the Study:
- To analyze national trends in psychotropic prescriptions for US children aged 2-5 years.
- To identify sociodemographic factors associated with psychotropic use in this age group.
Main Methods:
- Utilized data from the National Ambulatory and National Hospital Ambulatory Medical Care Surveys (1994-2009).
- Employed multivariable logistic regression to identify predictors of psychotropic use.
- Examined temporal trends in 4-year blocks.
Main Results:
- Psychotropic prescription rates varied, peaking at 1.45% in 2002-2005.
- Boys, white children, older preschoolers (4-5 years), and children lacking private insurance showed higher odds of prescription.
- Rates stabilized between 2006-2009, not differing significantly from earlier periods.
Conclusions:
- Psychotropic prescribing in young children exhibited a peak in 2002-2005, alongside significant sociodemographic disparities.
- Further research is needed to understand the stabilization of use post-2005 and the reasons behind increased prescribing in specific subgroups.
Objective:
To examine recent national trends in psychotropic use for very young children at US outpatient medical visits.
Methods:
Data for 2- to 5-year-old children (N = 43 598) from the 1994-2009 National Ambulatory and National Hospital Ambulatory Medical Care Surveys were used to estimate the weighted percentage of visits with psychotropic prescriptions. Multivariable logistic regression was used to identify factors associated with psychotropic use. Time effects were examined in 4-year blocks (1994-1997, 1998-2001, 2002-2005, and 2006-2009).
Results:
Psychotropic prescription rates were 0.98% from 1994-1997, 0.83% from 1998-2001, 1.45% from 2002-2005, and 1.00% from 2006-2009. The likelihood of preschool psychotropic use was highest in 2002-2005 (1994-1997 adjusted odds ratio [AOR] versus 2002-2005: 0.67; 1998-2001 AOR versus 2002-2005: 0.63; 2006-2009 AOR versus 2002-2005: 0.64), then diminished such that the 2006-2009 probability of use did not differ from 1994-1997 or from 1998-2001. Boys (AOR versus girls: 1.64), white children (AOR versus other race: 1.42), older children (AOR for 4 to 5 vs 2 to 3 year olds: 3.87), and those lacking private insurance (AOR versus privately insured: 2.38) were more likely than children from other groups to receive psychotropic prescriptions.
Conclusions:
Psychotropic prescription was notable for peak usage in 2002-2005 and sociodemographic disparities in use. Further study is needed to discern why psychotropic use in very young children stabilized in 2006-2009, as well as reasons for increased use in boys, white children, and those lacking private health insurance.
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