Patterns and correlates of tic disorder diagnoses in privately and publicly insured youth

Mark Olfson, Stephen Crystal, Tobias Gerhard, Cecilia Huang, James T. Walkup, Lawrence Scahill, John T. Walkup

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective This study examined the prevalence and demographic and clinical correlates of children diagnosed with Tourette disorder, chronic motor or vocal tic disorder, and other tic disorders in public and private insurance plans over the course of a 1-year period. Method Claims were reviewed of Medicaid (n = 10,247,827) and privately (n = 16,128,828) insured youth (4-18 years old) focusing on tic disorder diagnoses during a 1-year period. Rates are presented for children with each tic disorder diagnosis overall and stratified by demographic characteristics and co-identified mental disorders. Mental health service use, including medications prescribed, and co-existing psychiatric disorders were also examined. Results In Medicaid-insured children, rates of diagnosis per 1,000 were 0.53 (95% confidence interval [CI] 0.51-0.55) for Tourette disorder, 0.08 (95% CI 0.07-0.08) for chronic motor or vocal tic disorder, and 0.43 (95% CI 0.41-0.44) for other tic disorders. In privately insured children, comparable rates were 0.50 (95% CI 0.49-0.52), 0.10 (95% CI 0.10-0.11), and 0.59 (95% CI 0.58-0.61). In 1 year, children diagnosed with tic disorders also frequently received other psychiatric disorder diagnoses. Compared with privately insured youth, children under Medicaid diagnosed with Tourette disorder had higher rates of attention-deficit/hyperactivity disorder (50.2% versus 25.9%), other disruptive behavior (20.6% versus 5.6%), and depression (14.6% versus 9.8%) diagnoses and higher rates of antipsychotic medication use (53.6% versus 33.2%). Conclusions Despite similarities in annual rates of tic disorder diagnoses in publicly and privately insured children, important differences exist in patient characteristics and service use of publicly and privately insured youth who are diagnosed with tic disorders.

Original languageEnglish (US)
Pages (from-to)119-131
Number of pages13
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume50
Issue number2
DOIs
StatePublished - Feb 1 2011

Fingerprint

Tic Disorders
Confidence Intervals
Tourette Syndrome
Medicaid
Mental Disorders
Demography
Mental Health Services
Attention Deficit Disorder with Hyperactivity
Insurance
Antipsychotic Agents
Psychiatry
Cross-Sectional Studies
Depression

Keywords

  • Tourette disorder
  • health care disparities
  • insurance databases
  • mental health services
  • tic disorder prevalence

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

Olfson, Mark ; Crystal, Stephen ; Gerhard, Tobias ; Huang, Cecilia ; Walkup, James T. ; Scahill, Lawrence ; Walkup, John T. / Patterns and correlates of tic disorder diagnoses in privately and publicly insured youth. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2011 ; Vol. 50, No. 2. pp. 119-131.
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title = "Patterns and correlates of tic disorder diagnoses in privately and publicly insured youth",
abstract = "Objective This study examined the prevalence and demographic and clinical correlates of children diagnosed with Tourette disorder, chronic motor or vocal tic disorder, and other tic disorders in public and private insurance plans over the course of a 1-year period. Method Claims were reviewed of Medicaid (n = 10,247,827) and privately (n = 16,128,828) insured youth (4-18 years old) focusing on tic disorder diagnoses during a 1-year period. Rates are presented for children with each tic disorder diagnosis overall and stratified by demographic characteristics and co-identified mental disorders. Mental health service use, including medications prescribed, and co-existing psychiatric disorders were also examined. Results In Medicaid-insured children, rates of diagnosis per 1,000 were 0.53 (95{\%} confidence interval [CI] 0.51-0.55) for Tourette disorder, 0.08 (95{\%} CI 0.07-0.08) for chronic motor or vocal tic disorder, and 0.43 (95{\%} CI 0.41-0.44) for other tic disorders. In privately insured children, comparable rates were 0.50 (95{\%} CI 0.49-0.52), 0.10 (95{\%} CI 0.10-0.11), and 0.59 (95{\%} CI 0.58-0.61). In 1 year, children diagnosed with tic disorders also frequently received other psychiatric disorder diagnoses. Compared with privately insured youth, children under Medicaid diagnosed with Tourette disorder had higher rates of attention-deficit/hyperactivity disorder (50.2{\%} versus 25.9{\%}), other disruptive behavior (20.6{\%} versus 5.6{\%}), and depression (14.6{\%} versus 9.8{\%}) diagnoses and higher rates of antipsychotic medication use (53.6{\%} versus 33.2{\%}). Conclusions Despite similarities in annual rates of tic disorder diagnoses in publicly and privately insured children, important differences exist in patient characteristics and service use of publicly and privately insured youth who are diagnosed with tic disorders.",
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Patterns and correlates of tic disorder diagnoses in privately and publicly insured youth. / Olfson, Mark; Crystal, Stephen; Gerhard, Tobias; Huang, Cecilia; Walkup, James T.; Scahill, Lawrence; Walkup, John T.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 50, No. 2, 01.02.2011, p. 119-131.

Research output: Contribution to journalArticle

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T1 - Patterns and correlates of tic disorder diagnoses in privately and publicly insured youth

AU - Olfson, Mark

AU - Crystal, Stephen

AU - Gerhard, Tobias

AU - Huang, Cecilia

AU - Walkup, James T.

AU - Scahill, Lawrence

AU - Walkup, John T.

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N2 - Objective This study examined the prevalence and demographic and clinical correlates of children diagnosed with Tourette disorder, chronic motor or vocal tic disorder, and other tic disorders in public and private insurance plans over the course of a 1-year period. Method Claims were reviewed of Medicaid (n = 10,247,827) and privately (n = 16,128,828) insured youth (4-18 years old) focusing on tic disorder diagnoses during a 1-year period. Rates are presented for children with each tic disorder diagnosis overall and stratified by demographic characteristics and co-identified mental disorders. Mental health service use, including medications prescribed, and co-existing psychiatric disorders were also examined. Results In Medicaid-insured children, rates of diagnosis per 1,000 were 0.53 (95% confidence interval [CI] 0.51-0.55) for Tourette disorder, 0.08 (95% CI 0.07-0.08) for chronic motor or vocal tic disorder, and 0.43 (95% CI 0.41-0.44) for other tic disorders. In privately insured children, comparable rates were 0.50 (95% CI 0.49-0.52), 0.10 (95% CI 0.10-0.11), and 0.59 (95% CI 0.58-0.61). In 1 year, children diagnosed with tic disorders also frequently received other psychiatric disorder diagnoses. Compared with privately insured youth, children under Medicaid diagnosed with Tourette disorder had higher rates of attention-deficit/hyperactivity disorder (50.2% versus 25.9%), other disruptive behavior (20.6% versus 5.6%), and depression (14.6% versus 9.8%) diagnoses and higher rates of antipsychotic medication use (53.6% versus 33.2%). Conclusions Despite similarities in annual rates of tic disorder diagnoses in publicly and privately insured children, important differences exist in patient characteristics and service use of publicly and privately insured youth who are diagnosed with tic disorders.

AB - Objective This study examined the prevalence and demographic and clinical correlates of children diagnosed with Tourette disorder, chronic motor or vocal tic disorder, and other tic disorders in public and private insurance plans over the course of a 1-year period. Method Claims were reviewed of Medicaid (n = 10,247,827) and privately (n = 16,128,828) insured youth (4-18 years old) focusing on tic disorder diagnoses during a 1-year period. Rates are presented for children with each tic disorder diagnosis overall and stratified by demographic characteristics and co-identified mental disorders. Mental health service use, including medications prescribed, and co-existing psychiatric disorders were also examined. Results In Medicaid-insured children, rates of diagnosis per 1,000 were 0.53 (95% confidence interval [CI] 0.51-0.55) for Tourette disorder, 0.08 (95% CI 0.07-0.08) for chronic motor or vocal tic disorder, and 0.43 (95% CI 0.41-0.44) for other tic disorders. In privately insured children, comparable rates were 0.50 (95% CI 0.49-0.52), 0.10 (95% CI 0.10-0.11), and 0.59 (95% CI 0.58-0.61). In 1 year, children diagnosed with tic disorders also frequently received other psychiatric disorder diagnoses. Compared with privately insured youth, children under Medicaid diagnosed with Tourette disorder had higher rates of attention-deficit/hyperactivity disorder (50.2% versus 25.9%), other disruptive behavior (20.6% versus 5.6%), and depression (14.6% versus 9.8%) diagnoses and higher rates of antipsychotic medication use (53.6% versus 33.2%). Conclusions Despite similarities in annual rates of tic disorder diagnoses in publicly and privately insured children, important differences exist in patient characteristics and service use of publicly and privately insured youth who are diagnosed with tic disorders.

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KW - health care disparities

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KW - mental health services

KW - tic disorder prevalence

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