Abstract
Purpose/Objective. The objective of our study was to provide an updated evaluation of the use of psychotropic medications among children aged 6-17, and to evaluate the association of psychotropic medication use and healthcare utilization.
Background/Rationale. According to the Centers for Disease Control and Prevention (CDC), an estimated five million children aged 5-17 receive treatment for mental health problems each year in the United States. The most recent study that evaluated the overall use of prescribed psychotropic drugs among children in the United States used data from 2011-2012.
Methods/Methodology. This was a secondary database analysis using the National Health and Nutrition Examination Survey (NHANES) 2013-2014, 2015-2016, 2017-2018 bi-annual cohort years. Children aged 6-17 at the time of the survey interview were included in the study. The primary exposure variable was defined as the use of psychotropic drugs. Count and percent were used to describe medication and healthcare use. The association of psychotropic medication use across biannual cohort, select sociodemographic and healthcare use variables were evaluated using uni- and multi-variable logistic regression models. Multi-variable models adjusted for age, race, and gender as covariables. Crude and adjusted odds ratios with 95% confidence intervals were used to report these associations. Alpha was set at 0.05.
Results/Findings. Our results showed that 421 (8%) participants were on psychotropic drugs. ADHD medications and antidepressants were the psychotropic drug classes with the highest prevalence among children and adolescents. Children that were non-Hispanic white, male and aged 12 to 17 years old were significantly more likely to be on a psychotropic drug.
Conclusions. This is the first pharmacoepidemiologic study to estimate the use of psychotropic drugs in children nationally since 2012. Results also showed that socioeconomic status does not determine the use of psychotropic medications in children. This study found that children who have been hospitalized in the past year are more likely to be on psychotropic medications, but the cause of hospitalization cannot be assessed through NHANES data. Access to healthcare plays a key role in the use of psychotropic drugs, as our adjusted and unadjusted models showed significant correlation to health visits, overnight hospital stays, insurance status, and mental health professional visits.
