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High-risk psychotropic medications for US children with trauma sequelae

  • E. R. Barnett (a1) and M. T. Concepcion Zayas (a2)

Abstract

Children exposed to trauma are predisposed to develop a number of mental health syndromes. They are prone to under-treatment with effective psychosocial interventions and over-treatment with high-risk psychotropic medications, especially polypharmacy and the use of antipsychotics for unapproved conditions. We review the evidence for psychosocial and pharmacological treatments for mental health problems associated with high exposure to childhood trauma – identifying those in foster care as an index group – and the frequency of high-risk pharmacological practices. We describe current efforts to reduce over-treatment of children with high-risk psychotropic medications and propose further recommendations to protect and provide effective care for these vulnerable children.

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Copyright

Corresponding author

Author for correspondence: Erin R. Barnett, E-mail: Erin.R.Barnett@dartmouth.edu

References

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Adams, ZW, McCart, MR, Zajac, K, Danielson, CK, Sawyer, GK, Saunders, BE and Kilpatrick, DG (2013) Psychiatric problems and trauma exposure in nondetained delinquent and nondelinquent adolescents. Journal of Clinical Child and Adolescent Psychology 42, 323331.
Allaire, BT, Raghavan, R and Brown, DS (2016) Morbid obesity and use of second generation antipsychotics among adolescents in foster care: evidence from Medicaid. Children & Youth Services Review 67, 2731.
Barclay, RP, Penfold, RB, Sullivan, D, Boydston, L, Wignall, J and Hilt, RJ (2017) Decrease in statewide antipsychotic prescribing after implementation of child and adolescent psychiatry consultation services. Health Services Research 52, 561578.
Barnett, ER, Concepcion Zayas, MT, Zisman-Ilani, Y and Bellonci, C (in press) Patient-centered psychiatric care for youth in foster care: a systematic and critical review. Journal of Public Child Welfare.
Bellonci, C and Carlson, GA (2016) 24.0 deprescribing in child and adolescent psychiatry: where, when, and how to safely reduce polypharmacy in clinical settings. Journal of the American Academy of Child & Adolescent Psychiatry 55, S37.
Brinkman, WB, Hartl Majcher, J, Poling, LM, Shi, G, Zender, M, Sucharew, H, Britto, MT and Epstein, JN (2013) Shared decision-making to improve attention-deficit hyperactivity disorder care. Patient Education and Counseling 93, 95101.
Burns, BJ, Phillips, SD, Wagner, HR, Barth, RP, Kolko, DJ, Campbell, Y and Landsverk, J (2004) Mental health need and access to mental health services by youths involved with child welfare: a national survey. Journal of the American Academy of Child and Adolescent Psychiatry 43, 960970.
Center for Health Care Strategies (2018) Improving the Use of Psychotropic Medication for Children in Foster Care: State Profiles. Available at https://www.chcs.org/resource/psychotropic-medication-stakeholder-engagement/.
Chan, E, Fogler, JM and Hammerness, PG (2016) Treatment of attention-deficit/hyperactivity disorder in adolescents: a systematic review. The Journal of the American Medical Association 315, 19972008.
Cohen, D, Bonnot, O, Bodeau, N, Consoli, A and Laurent, C (2012) Adverse effects of second-generation antipsychotics in children and adolescents: a Bayesian meta-analysis. Journal of Clinical Psychopharmacology 32, 309316.
Cohen, JA, Deblinger, E and Mannarino, AP (2018) Trauma-focused cognitive behavioral therapy for children and families. Psychotherapy Research 28, 4757.
Cox, GR, Callahan, P, Churchill, R, Hunot, V, Merry, SN, Parker, AG and Hetrick, SE (2014) Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents. The Cochrane Database of Systematic Reviews 14, 11.
De Bellis, MD and Zisk, A (2014) The biological effects of childhood trauma. Child and Adolescent Psychiatric Clinics of North America 23, 185222, vii.
Delate, T, Kauffman, YS, Botts, SR, Wong, C and Gaughan, KM (2014) Metabolic monitoring in commercially insured pediatric patients newly initiated to take a second-generation antipsychotic. JAMA Pediatrics 168, 679681.
dosReis, S, Zito, JM, Safer, DJ and Soeken, KL (2001) Mental health services for youths in foster care and disabled youths. American Journal of Public Health 91, 10941099.
dosReis, S, Yoon, Y, Rubin, DM, Riddle, MA, Noll, E and Rothbard, A (2011) Antipsychotic treatment among youth in foster care. Pediatrics 128, e1459e1466.
Eyberg, SM, Nelson, MM and Boggs, SR (2008) Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology 37, 215237.
Fabiano, GA, Pelham, WE Jr, Coles, EK, Gnagy, EM, Chronis-Tuscano, A and O'Connor, BC (2009) A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review 29, 129140.
Felitti, VJ, Anda, RF, Nordenberg, D, Williamson, DF, Spitz, AM, Edwards, V, Koss, MP and Marks, JS (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine 14, 245258.
Finkelhor, D, Turner, H, Hamby, S and Ormrod, R (2011) Polyvictimization: Children's Exposure to Multiple Types of Violence, Crime, and Abuse (NCJ 235504). Washington, DC: US Government Printing Office.
Hetrick, SE, Cox, GR, Witt, KG, Bir, JJ and Merry, SN (2016) Cognitive behavioural therapy (CBT), third-wave CBT and interpersonal therapy (IPT) based interventions for preventing depression in children and adolescents. The Cochrane Database of Systematic Reviews 9, 8.
Jureidini, J, Tonkin, A and Jureidini, E (2013) Combination pharmacotherapy for psychiatric disorders in children and adolescents: prevalence, efficacy, risks and research needs. Paediatric Drugs 15, 377391.
Kerker, BD, Zhang, J, Nadeem, E, Stein, RE, Hurlburt, MS, Heneghan, A, Landsverk, J and McCue Horwitz, S (2015) Adverse childhood experiences and mental health, chronic medical conditions, and development in young children. Academic Pediatrics 15, 510517.
Kilpatrick, DG, Resnick, HS, Milanak, ME, Miller, MW, Keyes, KM and Friedman, MJ (2013) National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. Journal of Traumatic Stress 26, 537547.
Kutz, G (2011) Foster Children: HHS Guidance Could Help States Improve Oversight of Psychotropic Prescriptions [GAO-12-270T]. Washington, DC: General Accounting Office.
Landsverk, JA, Burns, B, Stambaugh, LF and Rolls-Reutz, J (2006) Mental health care for children and adolescents in foster care: Review of research literature. Available at http://www.casey.org/Resources/Publications/pdf/MentalHealthCareChildren.pdf (Accessed August 2018).
Lee, T, Fouras, G and Brown, R (2015) Practice parameter for the assessment and management of youth involved with the child welfare system. Journal of the American Academy of Child and Adolescent Psychiatry 54, 502517.
Leslie, LK, Raghavan, R, Zhang, J and Aarons, GA (2010) Rates of psychotropic medication use over time among youth in child welfare/child protective services. Journal of Child and Adolescent Psychopharmacology 20, 135143.
Lowe, SR, Blachman-Forshay, J and Koenen, KC (2015) Trauma as a public health issue: Epidemiology of trauma and trauma-related disorders. In Schnyder, U and Cloitre, M (eds), Evidence Based Treatments for Trauma-Related Psychological Disorders. Switzerland: Springer International Publishing, pp. 1140.
Mackie, TI, Hyde, J, Palinkas, LA, Niemi, E and Leslie, LK (2017) Fostering psychotropic medication oversight for children in foster care: a national examination of states’ monitoring mechanisms. Administration & Policy in Mental Health 44, 243257.
McLaren, JL, Brunette, MF, McHugo, GJ, Drake, RE and Daviss, WB (2017) Monitoring of patients on second-generation antipsychotics: a national survey of child psychiatrists. Psychiatric Services 68, 958961.
McLaren, JL, Barnett, ER, Concepcion Zayas, MT, Lichtenstein, J, Acquilano, SC, Schwartz, LM, Woloshin, S and Drake, RE (2018) Psychotropic medications for highly vulnerable children. Expert Opinion on Pharmacotherapy 19, 547560.
Morina, N, Koerssen, R and Pollet, TV (2016) Interventions for children and adolescents with posttraumatic stress disorder: a meta-analysis of comparative outcome studies. Clinical Psychology Review 47, 4154.
Narendorf, SC and McMillen, JC (2010) Substance use and substance use disorders as foster youth transition to adulthood. Children and Youth Services Review 32, 113119.
Noonan, K and Miller, D (2013) Fostering transparency: a preliminary review of policy governing psychotropic medications in foster care. Hastings Law Journal 65, 1551.
Oswald, SH, Heil, K and Goldbeck, L (2010) History of maltreatment and mental health problems in foster children: a review of the literature. Journal of Pediatric Psychology 35, 462472.
Patient Centered Outcomes Research Institute (2018) Comparing Effects of State Policies to Monitor Mental Health Medicines Given to Children in Foster Care. Available at https:// www.pcori.org/research-results/2015/comparing-effects-state-policies-monitor-mental-health-medicines-given (Accessed 1 September 2018).
Pennap, D, Burcu, M, Safer, DJ and Zito, JM (2018) The impact of a state Medicaid peer-review authorization program on pediatric use of antipsychotic medications. Psychiatric Services 69, 293299.
Raghavan, R and McMillen, JC (2008) Use of multiple psychotropic medications among adolescents aging out of foster care. Psychiatric Services 59, 10521055.
Romanelli, LH, Landsverk, J, Levitt, JM, Leslie, LK, Hurley, MM, Bellonci, C, Gries, LT, Pecora, PJ, Jensen, PS and Child Welfare-Mental Health Best Practices G (2009) Best practices for mental health in child welfare: screening, assessment, and treatment guidelines. Child Welfare 88, 163188.
Thackeray, J, Crane, D, Fontanella, C, Sorter, M, Baum, R and Applegate, M (2018) A Medicaid quality improvement collaborative on psychotropic medication prescribing for children. Psychiatric Services 69, 501504.
US Department of Health and Human Services Administration for Children Youth and Families Children's Bureau (2012) Information Memorandum Promoting the Safe, Appropriate, and Effective Use of Psychotropic Medication for Children in Foster Care. Available at http://www.acf.hhs.gov/programs/cb/resource/im1203.
US Department of Health and Human Services, Administration for Children and Families Children's Bureau (2017) National Child Abuse and Neglect Data System (NCANDS) child File, FFY 2000–2016.
Vanderwerker, L, Akincigil, A, Olfson, M, Gerhard, T, Neese-Todd, S and Crystal, S (2014) Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths. Psychiatric Services 65, 12811284.
Wang, Z, Whiteside, SPH, Sim, L, Farah, W, Morrow, AS, Alsawas, M, Barrionuevo, P, Tello, M, Asi, N, Beuschel, B, Daraz, L, Almasri, J, Zaiem, F, Larrea-Mantilla, L, Ponce, OJ, LeBlanc, A, Prokop, LJ and Murad, MH (2017) Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis. JAMA Pediatrics 171, 10491056.
Zeanah, CH, Scheeringa, M, Boris, NW, Heller, SS, Smyke, AT and Trapani, J (2004) Reactive attachment disorder in maltreated toddlers. Child Abuse & Neglect 28, 877888.
Zito, JM, Safer, DJ, Sai, D, Gardner, JF, Thomas, D, Coombes, P, Dubowski, M and Mendez-Lewis, M (2008) Psychotropic medication patterns among youth in foster care. Pediatrics 121, e157e163.
Zuddas, A, Zanni, R and Usala, T (2011) Second generation antipsychotics (SGAs) for non-psychotic disorders in children and adolescents: a review of the randomized controlled studies. European Neuropsychopharmacology 21, 600620.

Keywords

High-risk psychotropic medications for US children with trauma sequelae

  • E. R. Barnett (a1) and M. T. Concepcion Zayas (a2)

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