TABLE 1.
Children and Young Adults Initiating Benzodiazepine or SSRI Treatment of an Anxiety Disorder, 2008–2016: Selected Patient Characteristics
| Selected Patient Characteristic | Children (6–17 y) | Young Adults (18–24 y) | ||
|---|---|---|---|---|
| Benzodiazepinea | SSRIb | Benzodiazepinea | SSRIb | |
| n = 12 840 | n = 107 875 | n = 57 684 | n = 122 084 | |
| Male sex, n (%) | 4774 (37.2) | 41 311 (38.3) | 19 836 (34.4) | 39 939 (32.7) |
| Age, mean (SD) | 14.6 (2.63) | 13.6 (3.03) | 21.3 (1.94) | 20.7 (1.97) |
| Anxiety disorder (previous 30 d), n (%) | ||||
| Unspecified anxiety | 5997 (46.7) | 45 929 (42.6) | 31 986 (55.5) | 63 050 (51.6) |
| Generalized anxiety disorder | 2097 (16.3) | 29 604 (27.4) | 8446 (14.6) | 29 010 (23.8) |
| Panic disorder | 1614 (12.6) | 3885 (3.6) | 7413 (12.9) | 6092 (5.0) |
| Adjustment disorder with anxiety | 1360 (10.6) | 13 326 (12.4) | 2664 (4.6) | 9097 (7.5) |
| Acute stress disorder | 406 (3.2) | 1293 (1.2) | 2207 (3.8) | 2811 (2.3) |
| Phobic disorder | 288 (2.2) | 686 (0.6) | 1032 (1.8) | 689 (0.6) |
| Social phobia | 110 (0.9) | 2794 (2.6) | 432 (0.7) | 2451 (2.0) |
| Other anxiety | 399 (3.1) | 3425 (3.2) | 1624 (2.8) | 4463 (3.7) |
| Multiple diagnoses | 569 (4.4) | 6933 (6.4) | 1880 (3.3) | 4421 (3.6) |
| Provider on recent anxiety diagnosis, n (%) | ||||
| Psychiatry | 1419 (11.1) | 24 611 (22.8) | 3907 (6.8) | 12 405 (10.2) |
| Psychology | 1872 (14.6) | 15 988 (14.8) | 2589 (4.5) | 8784 (7.2) |
| Pediatrician | 1992 (15.5) | 21 536 (20.0) | 1346 (2.3) | 5456 (4.5) |
| Family practitioner | 2248 (17.5) | 15 811 (14.7) | 19 595 (34.0) | 46 877 (38.4) |
| Other general (nurse practitioner, internal medicine) | 1136 (8.8) | 9159 (8.5) | 10 830 (18.8) | 22 831 (18.7) |
| Other provider type | 2168 (16.9) | 12 663 (11.7) | 10 022 (17.4) | 14 576 (11.9) |
| Unknown or multiple provide types | 2005 (15.6) | 8107 (7.5) | 9395 (16.3) | 11 155 (9.1) |
| Recent psychiatric diagnoses (0–30 d), n (%) | ||||
| ADHD | 1006 (7.8) | 16 775 (15.6) | 3142 (5.4) | 7751 (6.3) |
| Depression | 1286 (10.0) | 29 418 (27.3) | 5698 (9.9) | 30 622 (25.1) |
| Sleep disorder | 519 (4.0) | 3234 (3.0) | 3130 (5.4) | 5944 (4.9) |
| Conduct disorder | 151 (1.2) | 3310 (3.1) | 100 (0.2) | 366 (0.3) |
| OCD | 144 (1.1) | 3085 (2.9) | 218 (0.4) | 1356 (1.1) |
| PTSD | 87 (0.7) | 1036 (1.0) | 372 (0.6) | 945 (0.8) |
| Any psychiatric comorbidity (1 y), n (%) | 4829 (37.6) | 65 353 (60.6) | 17 719 (30.7) | 53 090 (43.5) |
| Nonpsychiatric diagnoses (1 y), n (%) | ||||
| Asthma | 1656 (12.9) | 11 044 (10.2) | 4608 (8.0) | 8368 (6.9) |
| Chest pain, palpitations | 1908 (14.9) | 6886 (6.4) | 10 893 (18.9) | 12 645 (10.4) |
| Dizziness, fainting | 1098 (8.6) | 5565 (5.2) | 4504 (7.8) | 6991 (5.7) |
| Muscle spasm | 420 (3.3) | 1964 (1.8) | 1844 (3.2) | 2933 (2.4) |
| Injury-related diagnoses (1 y unless specified), n (%) | ||||
| Fracture (91 d–1 y) | 500 (3.9) | 3462 (3.2) | 1089 (1.9) | 2075 (1.7) |
| Injury diagnosis (excluding fracture) | 3242 (25.2) | 22 896 (21.2) | 10 918 (18.9) | 20 830 (17.1) |
| Fall diagnosis | 168 (1.3) | 1422 (1.3) | 453 (0.8) | 959 (0.8) |
| Joint disorder, nontraumatic | 2143 (16.7) | 14 316 (13.3) | 6903 (12.0) | 13 929 (11.4) |
| Recent prescriptions (0–90 d), n (%) | ||||
| Stimulant | 1266 (9.9) | 15 714 (14.6) | 4445 (7.7) | 8576 (7.0) |
| Antidepressant (baseline SSRI use excluded) | 1085 (8.5) | 5204 (4.8) | 6677 (11.6) | 8163 (6.7) |
| Anticonvulsant | 426 (3.3) | 1599 (1.5) | 1319 (2.3) | 1997 (1.6) |
| Antipsychotic, lithium | 364 (2.8) | 2411 (2.2) | 659 (1.1) | 1054 (0.9) |
| Hypnotic | 110 (0.9) | 361 (0.3) | 1390 (2.4) | 2196 (1.8) |
| Opioid | 1422 (11.1) | 4770 (4.4) | 7590 (13.2) | 10 555 (8.6) |
| Psychotherapy claims (recent, 0–30 d), n (%) | 3796 (29.6) | 46 604 (43.2) | 6359 (11.0) | 21 226 (17.4) |
| ED visits (recent, 0–30 d), n (%) | 3627 (28.2) | 10 191 (9.4) | 14 766 (25.6) | 12 462 (10.2) |
| Preventive outpatient visit (1 y), n (%) | 6527 (50.8) | 59 937 (55.6) | 23 394 (40.6) | 53 053 (43.5) |
OCD, obsessive compulsive disorder; PTSD, posttraumatic stress disorder.
a
Benzodiazepine treatment included prescriptions for alprazolam, chlordiazepoxide, clobazam, clonazepam, clorazepate, diazepam, estazolam, flurazepam, halazepam, lorazepam, midazolam, oxazepam, prazepam, quazepam, temazepam, or triazolam.
b
SSRI treatment included dispensed prescription for citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, or vilazodone.