Psychiatric Diagnoses and Medication Use in Children Insured by Medicaid

Bottom Line: Young children insured by Medicaid with a psychiatric diagnosis had early and prolonged exposure to psychotropic medications.

Why The Research Is Interesting: Treated psychiatric diagnoses and the use of psychotropic medications has increased in the pediatric population amid concerns of off-label prescription of medication use (not approved by the U.S. Food and Drug Administration). The short- and long-term effects of early exposure to complex combinations of medications are unknown.

Who and When: Medicaid claims data for 35,244 children born in a mid-Atlantic state in 2007 and followed up through 2014

What (Study Measures): Mental health treatments from birth through age 7 (exposures); cumulative incidence (frequency over time) of a first psychiatric diagnosis and psychotropic medication use from birth through age 7 and duration of medication use (outcomes)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control for all other factors that could explain the study findings.

Authors: Dinci Pennap, M.P.H., and Julie Zito, Ph.D., of the University of Maryland, Baltimore, and coauthors


Study Limitations: Medicaid data from one state; study captured medication dispensed not consumed; but longitudinal (over time) analysis of  one group of children assessed across eight years permitted a cumulative assessment of outcomes

Study Conclusions: The study highlights the need for safety and outcomes research after initiating psychotropic medication use in very young populations of children, particularly for health outcomes.

Related Material: An editor article review podcast with Aaron E. Carroll, M.D., M.S., JAMA Pediatrics digital media editor, also is available on the For The Media website. The transcript is available here.

