Psychiatric Diagnoses and Treatment Preceding Schizophrenia in Adolescents Aged 9–17 Years
ObjectiveOur study aimed to examine psychiatric diagnoses and treatment preceding a schizophrenia diagnosis in adolescents, stratified by sex and race/ethnicity.MethodsUsing Medicaid physical and behavioral health and pharmacy claims data, we identified 1,459 adolescents who were aged 9–17 years and...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-06-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2020.00487/full |
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| author | Christina D. Kang-Yi Christina D. Kang-Yi Brian Chao Shelly Teng Jill Locke David S. Mandell David S. Mandell Yin-Ling Irene Wong C. Neill Epperson |
| author_facet | Christina D. Kang-Yi Christina D. Kang-Yi Brian Chao Shelly Teng Jill Locke David S. Mandell David S. Mandell Yin-Ling Irene Wong C. Neill Epperson |
| author_sort | Christina D. Kang-Yi |
| collection | DOAJ |
| description | ObjectiveOur study aimed to examine psychiatric diagnoses and treatment preceding a schizophrenia diagnosis in adolescents, stratified by sex and race/ethnicity.MethodsUsing Medicaid physical and behavioral health and pharmacy claims data, we identified 1,459 adolescents who were aged 9–17 years and diagnosed with schizophrenia between January 2006 through June 2009. Psychiatric diagnosis, mental health service use including psychiatric hospitalization, residential treatment and outpatient therapy and psychotropic medication use preceding schizophrenia were identified.ResultsForty-five percent of the adolescents were diagnosed with one or more psychiatric conditions. More than 40% of the adolescents were hospitalized or placed in a residential treatment facility for other psychiatric conditions preceding schizophrenia. Overall, 72% of the adolescents were prescribed with one or more psychotropic medications and 22% were prescribed with three or more psychotropic medications in the year prior to their first schizophrenia diagnosis. We found that sex and race/ethnicity influence preceding psychiatric conditions and psychiatric treatment use.ConclusionsCareful screening and evaluation to validate diagnoses is important as the presence of certain psychiatric morbidity is common among adolescents with schizophrenia during the prodromal period. Developing acceptable and accessible interventions that will reduce psychiatric hospitalization and residential treatment care and improve care connection for schizophrenia treatment is important to mitigate complexity in treatment for adolescents and reduce cost burden for families and the society. Integrating health claims data in the development of schizophrenia risk conversion models can be useful in effectively predicting ideal timing of tailored interventions for adolescents with preceding psychiatric conditions. |
| first_indexed | 2024-12-10T23:51:34Z |
| format | Article |
| id | doaj.art-a3d8bf4769284398966e17b326070211 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-10T23:51:34Z |
| publishDate | 2020-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-a3d8bf4769284398966e17b3260702112022-12-22T01:28:44ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402020-06-011110.3389/fpsyt.2020.00487532869Psychiatric Diagnoses and Treatment Preceding Schizophrenia in Adolescents Aged 9–17 YearsChristina D. Kang-Yi0Christina D. Kang-Yi1Brian Chao2Shelly Teng3Jill Locke4David S. Mandell5David S. Mandell6Yin-Ling Irene Wong7C. Neill Epperson8Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesThe Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Education, Loyola Marymount University, Los Angeles, CA, United StatesIcahn School of Medicine at Mount Sinai, New York, NY, United StatesSpeech and Hearing Sciences, University of Washington, Seattle, WA, United StatesDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesThe Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United StatesSchool of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Psychiatry, School of Medicine, University of Colorado, Denver, CO, United StatesObjectiveOur study aimed to examine psychiatric diagnoses and treatment preceding a schizophrenia diagnosis in adolescents, stratified by sex and race/ethnicity.MethodsUsing Medicaid physical and behavioral health and pharmacy claims data, we identified 1,459 adolescents who were aged 9–17 years and diagnosed with schizophrenia between January 2006 through June 2009. Psychiatric diagnosis, mental health service use including psychiatric hospitalization, residential treatment and outpatient therapy and psychotropic medication use preceding schizophrenia were identified.ResultsForty-five percent of the adolescents were diagnosed with one or more psychiatric conditions. More than 40% of the adolescents were hospitalized or placed in a residential treatment facility for other psychiatric conditions preceding schizophrenia. Overall, 72% of the adolescents were prescribed with one or more psychotropic medications and 22% were prescribed with three or more psychotropic medications in the year prior to their first schizophrenia diagnosis. We found that sex and race/ethnicity influence preceding psychiatric conditions and psychiatric treatment use.ConclusionsCareful screening and evaluation to validate diagnoses is important as the presence of certain psychiatric morbidity is common among adolescents with schizophrenia during the prodromal period. Developing acceptable and accessible interventions that will reduce psychiatric hospitalization and residential treatment care and improve care connection for schizophrenia treatment is important to mitigate complexity in treatment for adolescents and reduce cost burden for families and the society. Integrating health claims data in the development of schizophrenia risk conversion models can be useful in effectively predicting ideal timing of tailored interventions for adolescents with preceding psychiatric conditions.https://www.frontiersin.org/article/10.3389/fpsyt.2020.00487/fullschizophreniapreceding psychiatric diagnosespreceding psychiatric treatmentadolescents aged 9–17 yearshealth claims data |
| spellingShingle | Christina D. Kang-Yi Christina D. Kang-Yi Brian Chao Shelly Teng Jill Locke David S. Mandell David S. Mandell Yin-Ling Irene Wong C. Neill Epperson Psychiatric Diagnoses and Treatment Preceding Schizophrenia in Adolescents Aged 9–17 Years Frontiers in Psychiatry schizophrenia preceding psychiatric diagnoses preceding psychiatric treatment adolescents aged 9–17 years health claims data |
| title | Psychiatric Diagnoses and Treatment Preceding Schizophrenia in Adolescents Aged 9–17 Years |
| title_full | Psychiatric Diagnoses and Treatment Preceding Schizophrenia in Adolescents Aged 9–17 Years |
| title_fullStr | Psychiatric Diagnoses and Treatment Preceding Schizophrenia in Adolescents Aged 9–17 Years |
| title_full_unstemmed | Psychiatric Diagnoses and Treatment Preceding Schizophrenia in Adolescents Aged 9–17 Years |
| title_short | Psychiatric Diagnoses and Treatment Preceding Schizophrenia in Adolescents Aged 9–17 Years |
| title_sort | psychiatric diagnoses and treatment preceding schizophrenia in adolescents aged 9 17 years |
| topic | schizophrenia preceding psychiatric diagnoses preceding psychiatric treatment adolescents aged 9–17 years health claims data |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2020.00487/full |
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