{"doi":"10.1016/j.jaacop.2024.09.010","title":"Impact of Social Determinants of Health and Professional Guidelines for Pharmacotherapy and Psychotherapy Recommendations for the Treatment of Young Children: A Retrospective Study","abstract":"To examine pharmacotherapy and psychotherapy treatment recommendations among different races and socioeconomic groups of young children. A secondary objective evaluated whether changes in the 2007 American Academy of Child and Adolescent Psychiatry (AACAP) guidelines for attention-deficit/hyperactivity disorder (ADHD) treatment affected community prescribing practices. We hypothesized that non-White children would be less likely to have psychotherapeutic treatments recommended for mental health issues and children with lower socioeconomic status index scores would be less likely to receive a psychotropic medication prescription. The sample included 1,764 children aged 7 years old or less prescribed at least 1 psychotropic medication for psychiatric indications between 2003 and 2019 identified through the Rochester Epidemiology Project. Data were examined with chi-square test and logistic regression models. In the sample, 29% were female, 1.6% Asian, 6.9% Black, 5.3% Hispanic, 7.7% other and 79% White. The most common psychiatric diagnosis was ADHD (91.6%). The majority of first prescriptions of psychotropic medications were written by family medicine physicians or pediatricians (69%) compared to psychiatrists. The recommendations were not affected by patient socioeconomic status, race and ethnicity group, or insurance (all p>0.18). Following the 2007 AACAP guideline updates, we found a significant increase in psychotherapy recommendations for children diagnosed with ADHD. For those under 6 years old, the rate rose from 54.4% to 65.5% after 2007 (p=0.002) and for those aged 6 to 7 years old, it increased from 45.7% to 52.7% (p=0.03). Children’s socioeconomic status, race and ethnicity, and insurance did not affect clinician’s treatment recommendations. However, children whose first prescription of psychotropic medication was from a family medicine physician or pediatrician were less likely to have a recommendation for psychotherapy compared to children who were seen by psychiatrists.","journal":"JAACAP Open","year":2024,"id":462529,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9592,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1292380,"name":"Maria Saliba","orcid":"0000-0002-7156-3826","position":1,"is_corresponding":false},{"id":1292381,"name":"Kierstin Utter","orcid":"0000-0001-7137-1560","position":2,"is_corresponding":false},{"id":851858,"name":"Tom Joshua Wy","orcid":null,"position":3,"is_corresponding":false},{"id":1292846,"name":"Alex Roth","orcid":null,"position":4,"is_corresponding":false},{"id":1292847,"name":"Juan F. Garzon Hincapie","orcid":null,"position":5,"is_corresponding":false},{"id":1292848,"name":"Tatsumi Yanaba","orcid":null,"position":6,"is_corresponding":false},{"id":1292382,"name":"Pedro Del Cioppo Vasques","orcid":"0000-0003-1434-1036","position":7,"is_corresponding":false},{"id":953361,"name":"Vanessa Pazdernik","orcid":"0000-0001-7566-7334","position":8,"is_corresponding":false},{"id":444157,"name":"Chung‐Il Wi","orcid":"0000-0001-8938-2997","position":9,"is_corresponding":false},{"id":1292849,"name":"Monica Taylor-Desir","orcid":null,"position":10,"is_corresponding":false},{"id":294680,"name":"Paul E. Croarkin","orcid":"0000-0001-6843-6503","position":11,"is_corresponding":false},{"id":672830,"name":"Magdalena Romanowicz","orcid":"0000-0002-4916-0625","position":12,"is_corresponding":false},{"id":1292379,"name":"Chris Wang","orcid":"0000-0002-5063-1324","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:04:24.680035Z","pmid":"41367989","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}