Diagnostic Patterns and Racial/Ethnic Differences in Antipsychotic Prescribing Among Privately Insured Youth

Area of Science:

• Child and Adolescent Psychiatry
• Health Services Research
• Pharmacology

Background:

• Antipsychotic prescribing patterns in youth are a growing concern.
• Understanding racial/ethnic disparities in pediatric mental health treatment is crucial.

Purpose of the Study:

• To examine antipsychotic prescribing patterns among privately insured youth.
• To investigate racial/ethnic differences in antipsychotic use.
• To analyze these differences within specific diagnostic subgroups.

Main Methods:

• Utilized Optum's Clinformatics® Data Mart Database (2009-2021).
• Analyzed 46,372 new antipsychotic users aged 6-17, matched with non-users.
• Compared antipsychotic use odds across racial/ethnic groups, including subgroups with ADHD, depressive, and disruptive behavior disorders.

Main Results:

• Over 61% of antipsychotic users lacked recorded FDA-approved diagnoses.
• Attention-deficit/hyperactivity disorder (ADHD) and depressive disorders were common (40% and 46%).
• Racial/ethnic minority youth had 25-60% lower odds of antipsychotic use overall, but differences diminished within diagnostic subgroups.

Conclusions:

• Most privately insured youth antipsychotic users lack documented FDA-approved indications.
• Observed racial/ethnic disparities may stem from upstream diagnostic or treatment access issues.
• Further research is needed to address potential inequities in pediatric mental healthcare.