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Mental Health Service Use Before and After Diagnosis of Early-Onset Bipolar Disorder

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Abstract

To investigate patterns of mental health services, psychotropic treatments, and psychiatric diagnoses received by youth diagnosed with bipolar disorder, insurance claims of 323 youth (ages 6–18 years) were examined from the 2000–2001 Thomson/Medstat-MarketScan(c) database. Longitudinal patterns are assessed 6 months prior and following a new treatment episode of bipolar disorder. Youth subgroups (i.e., continuous, intermittent, and discontinuous services), defined by persistence of claims associated with a bipolar diagnosis, are compared by demographic and clinical characteristics. Virtually all youth had high rates of mental health service use and treatment immediately following initial bipolar diagnosis, but only half continued to receive services 6 months following diagnosis. A continuous pattern of claims associated with a bipolar diagnosis was associated with using more resources, receiving initial diagnosis from a mental health professional, being in a managed care plan, and having more psychiatric diagnoses following index bipolar diagnosis. Further research should examine how continuity of claims for bipolar is related to treatment quality and clinical outcomes.

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Acknowledgements

I am thankful to my mentors including Drs. Donald Steinwachs, Elizabeth Kastelic, and Thomas Louis, for their helpful comments on design and interpretation of this study. We are grateful to Thomson/Medstat for providing data.

Funding/Support

This study was supported by a grant from the National Institute of Mental Health (T32 MH 19545).

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Authors and Affiliations

  1. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA

    Sara E. Evans-Lacko PhD

  2. Health Service and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, London, SE5 8AF, United Kingdom

    Sara E. Evans-Lacko PhD

  3. Department of Psychiatry, Division of Child & Adolescent Psychiatry, The Johns Hopkins University School of Medicine, Meyer 3-166A, 600 N. Wolfe Street, Baltimore, MD, 21287, USA

    Susan dosReis PhD & Elizabeth Kastelic MD

  4. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, E4539 Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA

    Anne W. Riley PhD

Authors
  1. Sara E. Evans-Lacko PhD
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  2. Susan dosReis PhD
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  3. Elizabeth Kastelic MD
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  4. Anne W. Riley PhD
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Corresponding author

Correspondence to Sara E. Evans-Lacko PhD.

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Evans-Lacko, S.E., dosReis, S., Kastelic, E. et al. Mental Health Service Use Before and After Diagnosis of Early-Onset Bipolar Disorder. J Behav Health Serv Res 38, 398–413 (2011). https://doi.org/10.1007/s11414-010-9225-8

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  • DOI: https://doi.org/10.1007/s11414-010-9225-8

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