{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:57:13Z","timestamp":1793145433193,"version":"4.5.0"},"reference-count":32,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"\n OBJECTIVE:<\/jats:title>\n To determine if adverse family factors are associated with a higher likelihood of psychotropic polypharmacy among US youth with a mental health condition.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n The 2009\u20132015 Medical Expenditure Panel Survey data were used to identify family characteristics of 5136 youth aged \u226418 years with an emotional or behavioral health condition. Family adversity was based on family size, number of parents in the household, parental education and income, and parent-reported physical and\/or cognitive or mental health disability. Cluster analysis identified family adversity subgroups. Polypharmacy was defined as 3 or more psychotropic classes (eg, stimulants, antipsychotics, antidepressants, mood stabilizers, and sedatives) in at least 1 interview round in a calendar year. Weighted logistic regression evaluated associations between family adversity and psychotropic polypharmacy among youth.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n Nearly half (47.8%) of youth lived with parents who had a disability. Parents in the least socioeconomically disadvantaged cluster mainly had a mental illness, and 94% of parents in the most socioeconomically disadvantaged cluster had a parent-reported physical and\/or cognitive disability and mental illness. Among youth, mood disorder (24.2%; 95% confidence interval [CI]: 12.6%\u201316.0%), antidepressant use (16.0%; 95% CI: 10.6%\u201321.5%), and antipsychotic use (7.5%; 95% CI: 5.4%\u20139.6%) were higher in the most socioeconomically disadvantaged cluster relative to the other clusters. Approximately 3% of youth received psychotropic polypharmacy. The odds of psychotropic polypharmacy were 2.7 (95% CI: 1.1\u20136.4) times greater among youth in the most relative to the least socioeconomically disadvantaged cluster.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Higher use of psychotropic polypharmacy among youth with parents who have multiple disabilities raises concerns about oversight and monitoring of complex psychotropic treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2019-2705","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T12:25:54Z","timestamp":1589891154000},"source":"Crossref","is-referenced-by-count":13,"title":["Family Adverse Experiences and Psychotropic Polypharmacy Among US Youth: 2009\u20132015"],"prefix":"10.1542","volume":"145","author":[{"given":"Susan","family":"dosReis","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengchen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danya M.","family":"Qato","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Camelo Castillo","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Reeves","sequence":"additional","affiliation":[{"name":"Division of Child and Adolescent Psychiatry, Department of Psychiatry, School of Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2020,6,1]]},"reference":[{"issue":"2","key":"2021121012453745700_B1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1001\/jamapediatrics.2013.431","article-title":"Medication use in US youth with mental disorders","volume":"167","author":"Merikangas","year":"2013","journal-title":"JAMA Pediatr"},{"issue":"21","key":"2021121012453745700_B2","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1056\/NEJMsa1413512","article-title":"Trends in mental health care among children and adolescents","volume":"372","author":"Olfson","year":"2015","journal-title":"N Engl J Med"},{"issue":"6","key":"2021121012453745700_B3","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1001\/archpsyc.63.6.679","article-title":"National trends in the outpatient treatment of children and adolescents with antipsychotic drugs","volume":"63","author":"Olfson","year":"2006","journal-title":"Arch Gen Psychiatry"},{"issue":"12","key":"2021121012453745700_B4","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1001\/archgenpsychiatry.2012.647","article-title":"National trends in the office-based treatment of children, adolescents, and adults with antipsychotics","volume":"69","author":"Olfson","year":"2012","journal-title":"Arch Gen Psychiatry"},{"issue":"6","key":"2021121012453745700_B5","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1176\/appi.ajp.160.6.1071","article-title":"National trends in the treatment of attention deficit hyperactivity disorder","volume":"160","author":"Olfson","year":"2003","journal-title":"Am J Psychiatry"},{"issue":"5","key":"2021121012453745700_B6","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1097\/00004583-200205000-00008","article-title":"National trends in the use of psychotropic medications by children","volume":"41","author":"Olfson","year":"2002","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"8","key":"2021121012453745700_B7","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1001\/archgenpsychiatry.2009.81","article-title":"National patterns in antidepressant medication treatment","volume":"66","author":"Olfson","year":"2009","journal-title":"Arch Gen Psychiatry"},{"issue":"1","key":"2021121012453745700_B8","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jaac.2015.09.020","article-title":"Access to psychosocial services prior to starting antipsychotic treatment among Medicaid-insured youth","volume":"55","author":"Finnerty","year":"2016","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"8","key":"2021121012453745700_B9","first-page":"736","article-title":"Psychotropic polypharmacy among children and youth receiving Medicaid, 2012-2015","volume":"24","author":"Lohr","year":"2018","journal-title":"J Manag Care Spec Pharm"},{"issue":"6","key":"2021121012453745700_B10","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1176\/appi.ps.201700357","article-title":"Psychotropic polypharmacy among youths with serious emotional and behavioral disorders receiving coordinated care services","volume":"69","author":"Wu","year":"2018","journal-title":"Psychiatr Serv"},{"issue":"7","key":"2021121012453745700_B11","doi-asserted-by":"crossref","first-page":"e744","DOI":"10.4088\/JCP.16m10884","article-title":"Differential risk of increasing psychotropic polypharmacy use in children diagnosed with ADHD as preschoolers","volume":"78","author":"Winterstein","year":"2017","journal-title":"J Clin Psychiatry"},{"issue":"1","key":"2021121012453745700_B12","doi-asserted-by":"crossref","first-page":"e53551","DOI":"10.1371\/journal.pone.0053551","article-title":"Multi-exposure and clustering of adverse childhood experiences, socioeconomic differences and psychotropic medication in young adults","volume":"8","author":"Bj\u00f6rkenstam","year":"2013","journal-title":"PLoS One"},{"key":"2021121012453745700_B13","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1186\/s13034-017-0206-z","article-title":"A longitudinal study of socioeconomic status, family processes, and child adjustment from preschool until early elementary school: the role of social competence","volume":"11","author":"Hosokawa","year":"2017","journal-title":"Child Adolesc Psychiatry Ment Health"},{"issue":"3","key":"2021121012453745700_B14","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1001\/jamapediatrics.2018.4360","article-title":"Association of constellations of parental risk with children\u2019s subsequent anxiety and depression: findings from a HUNT survey and health registry study","volume":"173","author":"Lund","year":"2019","journal-title":"JAMA Pediatr"},{"issue":"7","key":"2021121012453745700_B15","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/j.socscimed.2011.06.011","article-title":"Childhood socio-economic status and the onset, persistence, and severity of DSM-IV mental disorders in a US national sample","volume":"73","author":"McLaughlin","year":"2011","journal-title":"Soc Sci Med"},{"issue":"14","key":"2021121012453745700_B16","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/j.jpsychires.2008.01.011","article-title":"What explains the relation between family poverty and childhood depressive symptoms?","volume":"42","author":"Tracy","year":"2008","journal-title":"J Psychiatr Res"},{"issue":"32","key":"2021121012453745700_B17","doi-asserted-by":"crossref","first-page":"882","DOI":"10.15585\/mmwr.mm6732a3","article-title":"Prevalence of disabilities and health care access by disability status and type among adults - United States, 2016","volume":"67","author":"Okoro","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"4","key":"2021121012453745700_B18","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.dhjo.2012.07.004","article-title":"Child and adult disability in the 2000 Census: disability is a household affair","volume":"5","author":"Shandra","year":"2012","journal-title":"Disabil Health J"},{"key":"2021121012453745700_B19","first-page":"189","article-title":"CDC health disparities and inequalities report \u2014United States, 2013","volume":"62","author":"Centers for Disease Control and Prevention","year":"2013","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"9","key":"2021121012453745700_B20","doi-asserted-by":"crossref","first-page":"e007062","DOI":"10.1136\/bmjopen-2014-007062","article-title":"Disabling chronic conditions in childhood and socioeconomic disadvantage: a systematic review and meta-analyses of observational studies","volume":"5","author":"Spencer","year":"2015","journal-title":"BMJ Open"},{"issue":"4","key":"2021121012453745700_B21","doi-asserted-by":"crossref","first-page":"E728","DOI":"10.3390\/ijerph15040728","article-title":"Race, socioeconomic status, and health during childhood: a longitudinal examination of racial\/ethnic differences in parental socioeconomic timing and child obesity risk","volume":"15","author":"Jones","year":"2018","journal-title":"Int J Environ Res Public Health"},{"issue":"7","key":"2021121012453745700_B22","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1001\/jamapediatrics.2019.1212","article-title":"Association of team sports participation with long-term mental health outcomes among individuals exposed to adverse childhood experiences","volume":"173","author":"Easterlin","year":"2019","journal-title":"JAMA Pediatr"},{"issue":"9","key":"2021121012453745700_B23","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1136\/oemed-2017-104319","article-title":"Childhood adversity, adult socioeconomic status and risk of work disability: a prospective cohort study","volume":"74","author":"Halonen","year":"2017","journal-title":"Occup Environ Med"},{"issue":"12","key":"2021121012453745700_B24","doi-asserted-by":"crossref","first-page":"2576","DOI":"10.1016\/j.socscimed.2007.06.010","article-title":"Modelling the contribution of changes in family life to time trends in adolescent conduct problems","volume":"65","author":"Collishaw","year":"2007","journal-title":"Soc Sci Med"},{"issue":"6","key":"2021121012453745700_B25","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s00127-004-0782-0","article-title":"The relative importance of child, family, school and neighbourhood correlates of childhood psychiatric disorder","volume":"39","author":"Ford","year":"2004","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"6","key":"2021121012453745700_B26","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1111\/j.1651-2227.2009.01638.x","article-title":"Social adversity predicts ADHD-medication in school children--a national cohort study","volume":"99","author":"Hjern","year":"2010","journal-title":"Acta Paediatr"},{"issue":"7","key":"2021121012453745700_B27","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1097\/00004583-201007000-00005","article-title":"Socioeconomic position predicts specialty mental health service use independent of clinical severity: the TRAILS study","volume":"49","author":"Amone-P\u2019Olak","year":"2010","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"9","key":"2021121012453745700_B28","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1097\/CHI.0b013e3181ae0a08","article-title":"Practice parameter on the use of psychotropic medication in children and adolescents","volume":"48","author":"Walkup","year":"2009","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"4","key":"2021121012453745700_B29","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.chc.2010.07.001","article-title":"Racial and ethnic disparities in pediatric mental health","volume":"19","author":"Alegria","year":"2010","journal-title":"Child Adolesc Psychiatr Clin N Am"},{"key":"2021121012453745700_B30","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1016\/j.childyouth.2012.04.006","article-title":"Interstate variation in trends of psychotropic medication use among Medicaid-enrolled children in foster care","volume":"34","author":"Rubin","year":"2012","journal-title":"Child Youth Serv Rev"},{"key":"2021121012453745700_B31","volume-title":"Psychotropic Medication Use Among Adolescents: United States, 2005-2010","author":"Jonas","year":"2013"},{"issue":"5","key":"2021121012453745700_B32","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.cppeds.2016.02.004","article-title":"Screening for social determinants of health among children and families living in poverty: a guide for clinicians","volume":"46","author":"Chung","year":"2016","journal-title":"Curr Probl Pediatr Adolesc Health Care"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2019-2705\/1079220\/peds_20192705.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2019-2705\/1079220\/peds_20192705.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T01:21:42Z","timestamp":1639185702000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/145\/6\/e20192705\/76900\/Family-Adverse-Experiences-and-Psychotropic"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,1]]},"references-count":32,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6,1]]},"published-print":{"date-parts":[[2020,6,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2019-2705","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,1]]},"article-number":"e20192705"}}