{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:49:16Z","timestamp":1785509356458,"version":"3.56.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To examine incidence of adverse health outcomes and associated factors among preschoolers (under age 6) who received antipsychotic treatment through the Florida Medicaid Prior Authorization (PA) program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using Florida's PA registry linked to the state's Medicaid claims data, we ascertained incident outcomes during PA-approved antipsychotic use between April 2008 and September 2015 (7.5 years). Six outcomes associated with use of antipsychotics included: diabetes, obesity, hyperlipidemia, hyperprolactinemia, cardiovascular disease (CVD) (including hypertension, ventricular arrhythmia, and other CVDs), and extrapyramidal symptoms (EPS) (including dystonia, akathisia, parkinsonism, and tardive dyskinesia). Outcome-specific incidences were stratified by short-term (\u22641 year) and long-term (&gt;1\u20137 years) antipsychotic use. We used multivariate modified Poisson regressions to determine factors associated with these outcomes among preschoolers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The overall crude incidence during PA-approved antipsychotic use was highest for EPS and obesity (57 and 19 cases\/1000 children-years, respectively). The rate of these two outcomes differed by duration of antipsychotic use. We observed a higher obesity (23.8 vs. 9.6,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and dystonia incidence (7.2 vs. 2.5,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05), but lower akathisia incidence (44.4 vs. 60.6,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) among long-term antipsychotic users compared with short-term users. Five outcomes\u2014ventricular arrhythmia, other cardiovascular side effects, hyperprolactinemia, parkinsonism, and tardive dyskinesia\u2014occurred rarely (&lt;2.0\/1000 children-years). Preschoolers who were younger at baseline (\u22642 years old vs. 4\u20135 years old) and Black (vs. White) were at a higher risk of EPS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Risk for EPS and obesity deserves clinical attention during antipsychotic treatment among preschoolers. Controlled studies that allow interpretation of these incidence rates in the context of background risk and that formally quantify the incremental risk associated with antipsychotic initiation during early childhood are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2017.0006","type":"journal-article","created":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T16:39:33Z","timestamp":1500050373000},"page":"833-839","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Physical Health Outcomes in Preschoolers with Prior Authorization for Antipsychotics"],"prefix":"10.1177","volume":"27","author":[{"given":"Yu-Jung","family":"Wei","sequence":"first","affiliation":[{"name":"University of Florida College of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Liu","sequence":"additional","affiliation":[{"name":"University of Florida College of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Rao","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"McPherson","sequence":"additional","affiliation":[{"name":"University of South Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Beth","family":"Jones","sequence":"additional","affiliation":[{"name":"Florida Agency for Health Care Administration"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Bussing","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almut G.","family":"Winterstein","sequence":"additional","affiliation":[{"name":"University of Florida College of Pharmacy"},{"name":"University of Florida Colleges of Medicine and Public Health & Health Professions"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,11,1]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-012-9561-7"},{"key":"e_1_3_2_3_1","unstructured":"Alker J Hoadley J: Medicaid Managed Care in Florida: Federal Waiver Approval and Implementation. 2013. Available from: http:\/\/ccf.georgetown.edu\/wp-content\/uploads\/2013\/10\/Florida-Medicaid-Brief_Fall2013.pdf (accessed April4 2017)."},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2189"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2006.0117"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-016-0963-x"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2010.09.011"},{"key":"e_1_3_2_8_1","unstructured":"Florida Medicaid Agency for Healthcare Administration: Medicaid Prescribed Drug Program: Spending Control Initiatives. 2011. 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