Table 2.
Frequencies and Rates of Diagnosis and Second-Generation Antipsychotic (SGA) Treatment among U.S. Medicaid-Enrolled Children
| 2002 | 2007 | |||||
|---|---|---|---|---|---|---|
| A: 3- to 5-Year Olds Diagnostic Cohort | Diagnoses* (%) N = 3,162,731 | SGA*(%) N = 7,838 0.25% | % of Total SGA* | Diagnoses* (%) N = 3,623,195 | SGA*(%) N = 13,059 0.36% | % of Total SGA* |
| No diagnoses | 92.87 | 0.04 | 14.19 | 91.35 | 0.04 | 11.28 |
| Single diagnosis | ||||||
| ADHD | 0.73 | 5.61 | 16.46 | 0.78 | 6.36 | 13.79 |
| Conduct disorder | 0.52 | 2.84 | 5.97 | 0.65 | 3.06 | 5.53 |
| Autism | 0.10 | 7.72 | 2.97 | 0.18 | 8.11 | 3.98 |
| Miscellaneous | 1.27 | 0.77 | 3.98 | 1.45 | 0.82 | 3.30 |
| Devel. delay or learning | 2.99 | 0.22 | 2.68 | 3.58 | 0.25 | 2.47 |
| Bipolar | 0.01 | 33.92 | 0.98 | 0.01 | 29.95 | 0.93 |
| Intellectual disability | 0.10 | 0.84 | 0.33 | 0.10 | 0.85 | 0.24 |
| Anxiety | 0.15 | 0.54 | 0.33 | 0.19 | 0.44 | 0.23 |
| Depression | 0.04 | 2.60 | 0.41 | 0.03 | 1.26 | 0.11 |
| Schizophrenia | 0.00 | 7.69 | 0.08 | 0.00 | 0.00 | 0.00 |
| Two diagnoses† | ||||||
| ADHD/conduct disorder | 0.16 | 12.78 | 8.39 | 0.23 | 15.89 | 10.12 |
| ADHD/miscellaneous | 0.10 | 10.62 | 4.34 | 0.12 | 12.74 | 4.09 |
| Autism/devel. delay or learning | 0.08 | 5.90 | 1.80 | 0.14 | 7.51 | 3.02 |
| ADHD/devel. delay or learning | 0.12 | 5.66 | 2.67 | 0.13 | 8.06 | 2.99 |
| Conduct/miscellaneous | 0.10 | 5.40 | 2.21 | 0.13 | 6.38 | 2.24 |
| ADHD/autism | 0.01 | 28.74 | 1.25 | 0.02 | 30.05 | 1.75 |
| ADHD/bipolar | 0.01 | 49.48 | 1.22 | 0.01 | 56.68 | 1.72 |
| Conduct/devel. delay or learning | 0.08 | 3.24 | 1.00 | 0.11 | 4.52 | 1.34 |
| ADHD/anxiety | 0.01 | 9.56 | 0.31 | 0.01 | 13.29 | 0.42 |
| Bipolar/conduct disorder | 0.00 | 58.82 | 0.51 | 0.00 | 52.58 | 0.39 |
| Other two diagnoses combinations | 0.26 | 2.86 | 2.96 | 0.30 | 3.68 | 3.11 |
| ≥ 3 diagnoses | 0.25 | 22.58 | 23.02 | 0.38 | 23.98 | 25.58 |
| 2002 | 2007 | |||||
|---|---|---|---|---|---|---|
| B: 6- to 11-Year Olds Diagnostic Cohort | Diagnoses (%) N = 5,462,434 | SGA (%) N = 80,006 1.5% | SGA(%) N = 80,006 1.5% | Diagnoses (%) N = 5,909,130 | SGA (%) N = 124,984 2.1% | % of Total SGA |
| No diagnoses | 86.31 | 0.20 | 11.63 | 84.26 | 0.25 | 10.11 |
| Single diagnosis | ||||||
| ADHD | 3.67 | 7.16 | 17.93 | 4.48 | 9.27 | 19.61 |
| Conduct disorder | 0.91 | 6.89 | 4.29 | 0.97 | 8.10 | 3.70 |
| Miscellaneous | 2.28 | 3.09 | 4.81 | 2.38 | 2.92 | 3.28 |
| Autism | 0.15 | 19.19 | 2.02 | 0.25 | 18.51 | 2.19 |
| Bipolar | 0.04 | 50.81 | 1.22 | 0.07 | 57.18 | 1.78 |
| Devel. delay or learning | 2.21 | 0.76 | 1.15 | 2.16 | 0.97 | 0.99 |
| Depression | 0.26 | 7.96 | 1.44 | 0.24 | 6.49 | 0.72 |
| Intellectual disability | 0.25 | 3.42 | 0.58 | 0.26 | 4.49 | 0.55 |
| Anxiety | 0.23 | 2.58 | 0.40 | 0.31 | 3.00 | 0.44 |
| Schizophrenia | 0.01 | 29.50 | 0.10 | 0.01 | 21.22 | 0.05 |
| Two diagnoses† | ||||||
| ADHD/conduct disorder | 0.55 | 18.95 | 7.09 | 0.79 | 22.90 | 8.59 |
| ADHD/miscellaneous | 0.50 | 14.59 | 5.01 | 0.61 | 17.02 | 4.90 |
| ADHD/bipolar | 0.04 | 63.05 | 1.81 | 0.10 | 69.98 | 3.26 |
| ADHD/devel. delay or learning | 0.36 | 7.66 | 1.90 | 0.43 | 10.45 | 2.12 |
| Conduct/miscellaneous | 0.22 | 13.04 | 1.92 | 0.23 | 14.26 | 1.56 |
| ADHD/autism | 0.03 | 35.63 | 0.82 | 0.07 | 39.27 | 1.34 |
| ADHD/depression | 0.11 | 20.03 | 1.52 | 0.11 | 21.48 | 1.09 |
| ADHD/anxiety | 0.05 | 12.87 | 0.48 | 0.10 | 15.97 | 0.74 |
| Autism/devel. delay or learning | 0.07 | 15.80 | 0.76 | 0.10 | 15.57 | 0.71 |
| Bipolar/conduct disorder | 0.01 | 59.72 | 0.47 | 0.02 | 68.32 | 0.64 |
| Other two diagnoses combinations | 0.36 | 11.24 | 2.75 | 0.38 | 15.14 | 2.73 |
| ≥ 3 Diagnoses | 1.01 | 38.26 | 26.38 | 1.32 | 42.34 | 26.33 |
| 2002 | 2007 | |||||
|---|---|---|---|---|---|---|
| C: 12-18 Year Olds Diagnostic Cohort | Diagnoses(%)N= 5,071,583 | SGA(%)N= 130,9192.6% | % of TotalSGA | Diagnoses(%)N= 5,929,130 | SGA(%)N= 216,3823.6% | % of TotalSGA |
| No diagnoses | 84.21 | 0.43 | 14.08 | 82.71 | 0.58 | 13.03 |
| Single diagnosis | ||||||
| ADHD | 2.42 | 9.43 | 8.86 | 3.19 | 12.01 | 10.50 |
| Conduct disorder | 1.62 | 8.29 | 5.21 | 1.62 | 9.88 | 4.37 |
| Bipolar | 0.15 | 44.33 | 2.65 | 0.30 | 49.44 | 4.04 |
| Miscellaneous | 2.79 | 5.22 | 5.65 | 2.52 | 5.48 | 3.78 |
| Depression | 1.29 | 8.48 | 4.24 | 1.31 | 8.88 | 3.18 |
| Autism | 0.11 | 31.18 | 1.36 | 0.19 | 28.68 | 1.53 |
| Intellectual disability | 0.45 | 5.14 | 0.89 | 0.44 | 7.59 | 0.92 |
| Anxiety | 0.41 | 3.28 | 0.52 | 0.54 | 4.01 | 0.59 |
| Devel. delay or learning | 1.30 | 1.44 | 0.72 | 0.96 | 2.20 | 0.58 |
| Schizophrenia | 0.03 | 61.43 | 0.74 | 0.03 | 56.67 | 0.40 |
| Two diagnoses† | ||||||
| ADHD/conduct disorder | 0.45 | 22.84 | 4.01 | 0.65 | 27.79 | 4.96 |
| ADHD/bipolar | 0.06 | 57.23 | 1.39 | 0.16 | 63.55 | 2.87 |
| ADHD/miscellaneous | 0.35 | 18.50 | 2.49 | 0.42 | 21.61 | 2.51 |
| Depression/miscellaneous | 0.56 | 14.87 | 3.24 | 0.49 | 14.94 | 2.00 |
| Conduct/miscellaneous | 0.41 | 14.58 | 2.29 | 0.37 | 16.93 | 1.73 |
| Bipolar/conduct disorder | 0.05 | 54.21 | 1.07 | 0.09 | 60.49 | 1.46 |
| ADHD/depression | 0.18 | 20.19 | 1.42 | 0.24 | 21.26 | 1.38 |
| Conduct/depression | 0.25 | 20.00 | 1.92 | 0.24 | 20.76 | 1.35 |
| Bipolar/depression | 0.06 | 43.06 | 0.97 | 0.09 | 49.61 | 1.17 |
| ADHD/devel. delay or learning | 0.16 | 10.41 | 0.65 | 0.16 | 14.18 | 0.62 |
| Other two diagnoses combinations | 0.59 | 22.23 | 5.09 | 0.63 | 27.67 | 4.79 |
| ≥ 3 Diagnoses | 1.70 | 42.79 | 28.12 | 2.15 | 49.93 | 29.36 |
*
Estimated from unadjusted conditional probabilities. From left to right within each year, the columns display the proportion of children receiving a diagnostic profile, the proportion of children receiving SGAs among those with the diagnostic profile, and finally, the proportion of all SGA use attributable to children with the diagnostic profile. For example, in 2002, 0.7% of children aged 3–5 had ADHD only. Of these 0.7%, 5.6% received SGA. Finally, children with ADHD only accounted for 16.5% of the total SGA users aged 3–5 in 2002.
†
Shown are the 10 two-diagnoses profiles with the greatest proportion of attributable SGA use in 2007. Unabbreviated two-diagnoses profile information is included in the online Appendix.