Table 3.
Cumulative Frequency of Non-psychotic Mental, Behavioral, and Neurodevelopmental Disorder Diagnoses and Antipsychotic Medication Prescriptions Dispensed in the Months Preceding a New Psychotic Disorder Diagnosis
| Percentage of Patients During the X Months Preceding a New Psychotic Disorder Diagnosis in 2016 (N = 2505) | ||||
|---|---|---|---|---|
| X = 12 | X = 24 | X = 36 | X = 48 | |
| Diagnosis category (ICD-10 F-code) | ||||
| Anxiety disorders (F40–F41) | 43.4 | 51.6 | 56.6 | 59.6 |
| Depressive disorders, non-psychotic (F32–F33, excl. F32.3, F33,3) | 42.9 | 51.7 | 56.2 | 59.6 |
| Adjustment disorders (F43) | 23.6 | 31.3 | 36.3 | 40.1 |
| Other/unspecified mood disorders (F34–F39, F99) | 19.3 | 28.5 | 34.0 | 37.6 |
| Bipolar disorders, non-psychotic (F30–F31, excl. F30.2, F31.2, F31.5, F31.64) | 21.2 | 25.5 | 28.7 | 30.5 |
| ADHD (F90) | 17.8 | 22.6 | 25.7 | 28.1 |
| Substance use disorders due to use of tobacco (F17) | 14.5 | 20.8 | 24.2 | 26.6 |
| Other | 28.5 | 35.8 | 41.4 | 45.4 |
| Any of the above diagnosis categories | 76.8 | 83.5 | 87.1 | 88.6 |
| Only one of the above diagnosis categories | 19.4 | 15.5 | 13.3 | 11.3 |
| Psychotropic medication category | ||||
| Antipsychotic | 36.6 | 40.6 | 43.4 | 45.6 |
| Antidepressant | 44.5 | 50.8 | 54.9 | 58.0 |
| Anti-anxiety | 35.6 | 41.7 | 45.2 | 48.6 |
| Subcategory: antipsychotic, long acting | 0.9 | 1.0 | 1.0 | 1.0 |
| Mood stabilizer | 24.0 | 27.7 | 30.7 | 32.5 |
| ADHD | 18.2 | 20.8 | 23.0 | 24.6 |
| Subcategory: ADHD, stimulants | 17.3 | 19.8 | 22.0 | 23.7 |
| Sub-subcategory: ADHD, stimulants, amphetamine | 13.5 | 15.2 | 16.8 | 17.9 |
| Any of the above medication categories | 66.5 | 71.5 | 74.4 | 77.0 |
| Only one of the above medication categories | 17.0 | 16.5 | 15.3 | 15.3 |
Notes: (1) The preceding period also included the days in the index diagnosis month but preceding the index diagnosis day. (2) ICD-9 to ICD-10 codes conversions were based on a crosswalk developed by the CMS and processed by the NBER. (3) ICD-10 categories were based on groupings by the WHO. (4) Diagnoses of substance use disorders (F10–F19 and corresponding ICD-9 codes) other than those due to use of tobacco (F17 and corresponding ICD-9 codes) were redacted from the data. (5) Other F-code categories include: Adjustment disorders (F43); Delirium (F05); Dementia (F01–F03); Developmental disorders (F80–F89); Disorders with onset in childhood (F91–F98); Eating disorders (F50); Gender identity disorders (F64); Impulse disorders (F63); Intellectual disabilities (F70–F79); OCD (F42); Organic syndromes (F04, F06–F09); Other behavioral syndromes associated with psychological distress/physical factors (F52–F59); Other stress disorders (F44–F48); Personality disorders (F60, F68–F69); Sexual disorders (F65–F66); Sleep disorders (F51). (6) ADHD, attention-deficit hyperactivity disorder. (7) Note, please see Supplementary table S8 for the percentage of patients who had non-psychotic disorder diagnoses with FDA-approved indications for antipsychotics preceding the new psychotic disorder diagnosis. Indications include: depression without psychosis (F32 excl. F32.3, F33 excl. F33.3), bipolar disorder without psychosis (F30 excl. F30.2, F31.0, F31.1, F31.3, F31.4, F31.6 excl. F31.64, F31.7–F31.9), severe childhood behavioral problems (F90–F98), generalized non-psychotic anxiety (F41.1), and agitation; irritability associated with autistic disorder (R45.1; F84.0).