Journal of the American Academy of Child & Adolescent Psychiatry
New researchPatterns and Correlates of Tic Disorder Diagnoses in Privately and Publicly Insured Youth
Section snippets
Data Sources
Service and pharmacy claims were examined from the MarketScan Research Databases (2000-2007) and a seven-state Medicaid Analytic Extract File (2001-2004) including California, Florida, New York, Texas, Illinois, Georgia, and Ohio. The states were selected for their large Medicaid populations, geographic diversity, and relatively low penetration of Medicaid managed care. MarketScan data include information from privately insured individuals and their family members. The data were collected
Rates of Tic Disorder Diagnosis by Demographic Characteristics
Annual rates of children with a Tourette disorder diagnosis did not differ substantially between private and public insurance plans. Children with chronic motor or vocal tic disorder were much less common than children with Tourette disorder and were somewhat more prevalent in private than public insurance plans (Table 1). The annual rates for children with any tic disorder diagnosis were 1.19 per 1,000 in the private insurance plans and 1.04 per 1,000 in public insurance (data not shown).
On an
Discussion
On the basis of claims patterns, a gradient of tic disorder diagnoses from unspecified and transient symptoms to the more chronic (chronic motor or vocal tic disorder) and potentially severe (Tourette disorder) tic disorders was observed in children in this study. This gradient was also associated with increasing rates of coexisting psychiatric disorder diagnoses, filled psychotropic prescriptions, and use of mental health services. A similar spectrum from milder and transient to persistent and
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Cited by (0)
This work was supported by award U18-HS016097 from the Agency for Healthcare Research and Quality (Center for Education and Research on Mental Health Therapeutics).
This article was reviewed under and accepted by Ad Hoc Editor James F. Leckman, M.D.
Drs. James T. Walkup and John T. Walkup are not related but have enjoyed the opportunity to work together on this project.
Disclosure: Dr. Olfson has received grant funding from Eli Lilly and Co. and Bristol Myers-Squibb. Dr. Scahill has served as a consultant to Shire Pharmaceuticals, NeuroSearch, Pfizer, and Boehringer-Ingelheim. He has also received research support from Shire and Seaside Therapeutics and received speaking honoraria for talks funded by a joint Tourette Syndrome Association-Center for Disease Control outreach and education program. He has received royalties from Oxford University Press and American Psychiatric Association Press. Dr. John T. Walkup has received active drug and placebo from Eli Lilly and Co. and Pfizer, and free drug from Abbott for National Institute of Mental Health-funded studies. He is also the Chair of the Medical Advisory Board of the Tourette Syndrome Association and receives travel support for meetings. He also has received honoraria for talks funded by a joint Tourette Syndrome Association-Center for Disease Control outreach and education program. He also receives royalties from Oxford University Press and Guilford Press. Drs. Crystal, Gerhard, Huang, and James T. Walkup report no biomedical financial interests or potential conflicts of interest.