Submission
| Title: | Racial-Ethnic Differences in Antipsychotic Initiation Among Youth with Diagnosed ADHD, Depression, or Conduct Disorder |
| Presenter: | Linnea Sepe-Forrest |
| Institution: | Indiana University Bloomington |
| Authors: | Linnea Sepe-Forrest1,2, Richard Meraz1, Sydney Adams1, Brian M. D’Onofrio1,2, Patrick D. Quinn1,2,3
Indiana University Bloomington: 1 Department of Psychological & Brain Sciences; 2 Program in Neuroscience, 3 School of Public Health |
Abstract
| Background/Significance/Rationale: | An up-to-date characterization of the commercially insured pediatric antipsychotic user population is important for evaluating whether such medications are prescribed according to evidence-based guidelines, especially among marginalized groups. This study examined racial-ethnic differences in antipsychotic initiation within psychiatric diagnostic groups as a follow-up to our prior work, which reported that, overall, youth from minority backgrounds had lower odds of initiating antipsychotics compared to White youth. |
| Methods: | This study used 2009-2021 data from Optum’s® Clinformatics® Data Mart, a database containing longitudinal patient information from nationwide commercial insurance claims. We created three separate samples of antipsychotic users and matched non-user controls between the ages of 6-17 years old. These groups contained individuals with clinically diagnosed ADHD, conduct disorder, and depressive disorder, respectively. We used conditional logistic regression to estimate the odds of antipsychotic initiation based on race-ethnicity within each diagnostic group. |
| Results/Findings: | There were no racial-ethnic differences in the odds of antipsychotic initiation among youth diagnosed with ADHD. Among youth with depression diagnoses, Asian youth had 20% lower odds of initiating antipsychotics and Hispanic youth had 10% lower odds compared with White youth. Similar results were observed for conduct disorders, with Asian and Black youth having 10% lower odds of initiating antipsychotic treatment and Hispanic youth having 20% lower odds relative to White youth. |
| Conclusions/Discussion: | Previously observed lower rates of antipsychotic initiation among racial-ethnic minority groups may be at least partially attributable to factors leading to disparities in diagnosis. Further research is needed to evaluate factors, such as clinical recognition and healthcare access, that may lead to differential antipsychotic use, as the disparities may occur upstream of receiving clinical diagnoses. |
| Translational/Human Health Impact: | This study can inform efforts to promote equitable and safe antipsychotic prescribing among youth from all racial-ethnic backgrounds in the United States by highlighting the role of upstream disparities associated with antipsychotic initiation rates. |
