Table 5:

Predictors of antipsychotic use without minimal antidepressant treatment among adults with new depressive episodes and no observed alternative clinical indications for antipsychotic treatment

	Minimal antidepressant treatmenta		No minimal antidepressant treatment		Adjusted Odds Ratiob (95% CI)
	N	%	N	%
TOTAL	37,591	28.7	93,585	71.3
DEMOGRAPHICc
Sex
Male	9,369	24.9	30,803	32.9	1.32 (1.28-1.36)
Female	28,222	75.1	62,782	67.1	Reference
Age
18-24	6,431	17.1	18,553	19.8	1.27 (1.20-1.34)
25-34	10,465	27.8	23,089	24.7	1.03 (0.97-1.08)
35-44	10,283	27.4	24,361	26.0	0.97 (0.92-1.02)
45-54	7,485	19.9	19,135	20.5	0.92 (0.88-0.97)
55-64	2,927	7.8	8,447	9.0	Reference
Race Ethnicity
White, non-Hispanic	21,693	57.7	46,457	49.6	Reference
African American, non-Hispanic	7,463	19.9	24,970	26.7	1.59 (1.54-1.64)
Hispanic	4,832	12.9	12,192	13.0	1.24 (1.19-1.28)
Other	3,603	9.6	9,966	10.7	1.25 (1.19-1.30)
Medicaid Eligibility
Disability	14,634	38.9	48,674	52.0	Reference
Low income	14,947	39.8	27,262	29.1	0.56 (0.54-0.57)
Other	8,010	21.3	17,649	18.9	0.62 (0.60-0.64)
Managed care (not FFS)	13,218	35.2	31,021	33.2	1.05 (1.02-1.08)
CLINICAL&UTILIZATIONd
Primary Depression Diagnosise	29,883	79.5	75,579	80.8	1.04 (1.01-1.08)
Major Depressive Disordere	16,589	44.1	43,484	46.5	1.08 (1.06-1.11)
Anxiety	3,887	10.3	9,176	9.8	0.96 (0.92-1.01)
Substance use disorder	5,754	15.3	16,290	17.4	1.06 (1.02-1.11)
Personality disorders	178	0.5	704	0.8	1.33 (1.12-1.58)
Self-harm	62	0.2	183	0.2	1.10 (0.82-1.48)
Diabetes	2,850	7.6	7,063	7.6	0.95 (0.91-1.00)
Cardiovascular Disease	6,726	17.9	16,295	17.4	0.87 (0.84-0.90)
Cerebrovascular Disease	663	1.8	1,736	1.9	0.95 (0.86-1.04)
Psychotherapy	1,206	3.2	3,073	3.3	0.97 (0.90-1.04)
MH ER visitf
No visit	36,094	96.0	88,359	94.4	Reference
1 to 2 visits	1,388	3.7	4,810	5.1	1.25 (1.16-1.34)
3 or more visits	109	0.3	416	0.4	1.26 (1.02-1.57)
MH hospital admissionsf
No admission	37,005	98.4	91,250	97.5	Reference
1+ admissions	586	1.6	2,335	2.5	1.31 (1.19-1.44)
MH outpatient visitsf
No visit	28,900	76.9	69,269	74.0	Reference
1 to 2 visits	4,731	12.6	12,767	13.6	1.04 (1.00-1.09)
3 or more visits	3,960	10.5	11,549	12.3	1.05 (1.00-1.11)

^adefined as AP initiation preceded by ≥31 days of AD supply AND active AD supply on the AP index date;

^bin addition to all variables shown in Table 5, the model also adjusted for index year;

^cat index date;

^dduring the 180 day baseline period including index date;

^ewithin Index date and index date+30 days;

^fprimary diagnosis;.

APM: antipsychotic medication; FFS: fee-for-service; MH: mental health; ER: emergency room