Table 6.
Simple and Multiple Logistic Regression to Determine Associations Between Predictors and Attention-Deficit/Hyperactivity Disorder (ADHD) Medications and Antidepressant (A/AD) Polypharmacy, N=629
| Simple logistic regressiona | Final model 2b | |||
|---|---|---|---|---|
| Variable | OR (95% CI) | p | OR (95% CI) | p |
| Demographics | ||||
| Gender (ref, male) | 0.64 (.32, 1.3) | 0.21 | – | – |
| Surveillance year identified (ref, 2000) | 0.02 | 0.01 | ||
| 2002 | 4.1 (1.7, 10.1) | 3.2 (1.2, 9.0) | ||
| 2004 | 2.4 (0.91, 6.4) | 2.1 (0.72, 6.4) | ||
| 2006 | 1.8 (0.69, 4.7) | 1.1 (0.35, 3.1) | ||
| 2008 | 2.0 (0.84, 5.0) | 0.82 (0.29, 2.3) | ||
| Residency (ref, urban) | 0.59 (0.33, 1.1) | 0.07 | – | – |
| Medicaid eligibility category (ref, disability)c | 1.2 (0.73, 2.1) | 0.42 | – | – |
| Race (ref, white) | 0.02 | 0.02 | ||
| Black | 0.39 (0.20, 0.79) | 0.37 (0.16, 0.84) | ||
| Otherd | 0.57 (0.33, 0.98) | 0.49 (0.26, 0.92) | ||
| Special education services (ref, autism) | 0.64 | – | – | |
| ASD- relatede | 1.3 (0.62, 2.7) | – | – | |
| Any otherf | 0.83 (0.46, 1.5) | – | – | |
| None | 0.77 (0.36, 1.6) | – | – | |
| Community assigned ASD diagnosisg | 0.91 (0.55, 1.5) | 0.73 | – | – |
| Aberrant behaviors as evidenced in each child's SC ADDM record | ||||
| Temper tantrums | 2.3 (1.3, 4.0) | <0.01 | – | – |
| Sensory issues | 1.5 (0.92, 2.5) | 0.10 | – | – |
| Staring spells/seizure-like activity | 1.3 (0.78, 2.2) | 0.31 | – | – |
| Mood abnormalities | 1.8 (1.1, 3.1) | 0.03 | – | – |
| Argumentative, defiant behavior | 4.4 (2.4, 8.2) | 0.01 | 2.2 (1.1, 4.6) | 0.03 |
| Aggression | 3.7 (2.1, 6.4) | <0.01 | 1.7 (0.89, 3.4) | 0.11 |
| Abnormal eating/drinking/sleeping | 2.5 (1.5, 4.4) | <0.01 | – | – |
| Abnormal cognitive development | 1.3 (0.82, 2.2) | 0.24 | – | – |
| Motor development delays | 0.67 (0.41, 1.1) | 0.11 | – | – |
| Abnormal fear response | 1.7 (1.1, 2.8) | 0.03 | – | – |
| Hyperactivity, inattention | 1.6 (0.72, 3.4) | 0.26 | – | – |
| Self-injurious behavior | 1.9 (1.2, 3.2) | 0.01 | – | – |
| ASD-specific DSM-IV diagnostic criteria as evidenced in SC ADDM records | ||||
| Social deficits | ||||
| Deficits in nonverbal behaviors | 1.2 (0.57, 2.5) | 0.63 | – | – |
| Poor peer relationships | 1.2 (0.69, 2.1) | 0.51 | – | – |
| Failure to share interests | 0.82 (0.50, 1.3) | 0.41 | – | – |
| Lack of or deficient emotional reciprocity | 1.1 (0.54, 2.4) | 0.75 | – | – |
| Communication deficits | ||||
| Delayed spoken language | 0.65 (0.26, 1.6) | 0.35 | – | – |
| Conversational deficits | 0.83 (0.43, 1.6) | 0.56 | – | – |
| Repetitive language | 0.78 (0.46, 1.3) | 0.37 | – | – |
| Deficits in imaginative play skills | 1.1 (0.68, 1.9) | 0.62 | – | – |
| Unusual behaviors | ||||
| Restricted interests | 1.1 (0.67, 1.8) | 0.71 | – | – |
| Abnormal routines and/or rituals | 1.6 (.84, 3.1) | 0.16 | – | – |
| Stereotyped motor mannerisms | 1.3 (.72, 2.3) | 0.40 | – | – |
| Abnormal preoccupation with parts of objects | 1.7 (1.0, 2.9) | 0.05 | 2.2 (1.1, 4.2) | 0.02 |
| Co-occurring conditions by ICD9 code in Medicaid claims files | ||||
| Any PDD | 1.7 (1.0, 3.0) | 0.04 | 1.5 (.78, 3.0) | 0.22 |
| ADHD | 10.8 (5.7, 20.5) | <0.01 | 6.4 (3.2, 13.1) | <0.01 |
| Anxiety or mood disorder | 3.9 (2.2, 7.0) | <0.01 | 2.4 (1.2, 5.0) | 0.02 |
| Communication disorder | 1.3 (0.77, 2.2) | 0.33 | – | – |
| Conduct disorder/ODD | 6.8 (4.0, 11.6) | <0.01 | 2.8 (1.5, 5.3) | <0.01 |
| Developmental disability | 0.68 (0.36, 1.3) | 0.24 | – | – |
| Epilepsy | 2.1 (1.2, 3.8) | 0.02 | – | – |
| Intellectual disability | 1.4 (0.80, 2.3) | 0.26 | – | – |
| Learning disability | 0.98 (0.57, 1.7) | 0.95 | – | – |
| Other mental health disorderh | 1.8 (1.0, 3.1) | 0.04 | – | – |
Simple logistic regression between predictor and outcome.
Final model: variables significantly associated with outcome after adjusting for demographic variables (0.10 level).
Disability versus foster care/income because of small numbers in foster care.
“Other race”=Hispanic, Asian/Pacific Islander, 1 missing.
“ASD related” special education=other health impairment (n=47), preschool child with disability (n=2), speech delay (n=20), developmental disability (n=2).
“Any other” special education=deaf-blindness, hearing impaired, mental retardation, multiple disabilities, orthopedic impairment, brain injury, visual impairment.
Community assigned diagnosis based on previous ASD diagnosis in education or medical records.
”Other mental health disorders”=adjustment disorder (n=21), delirium, dementia (n=3), motor skills disorder (n=5), elimination disorder (n=9), separation anxiety (n=3), emotional disorder (n=2), catatonic disorder (n=3), schizophrenia (n=1), psychogenic disorder (n=2), sleep disorder (n=15), and somatoform disorder (n=2).
ASD, autism spectrum disorder; SC ADDM-, South Carolina Autism and Developmental Disabilities Monitoring Network; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th ed.; ICD9, International Classification of Diseases, 9th Revision; PDD, pervasive developmental disorder; ODD, oppositional defiant disorder.