Skip to main content
SpringerLink
Log in

Patterns of Psychotropic Medication at Admission for Youth in Residential Care

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

High levels of psychotropic medication use and polypharmacy are common for emotionally and behaviorally troubled youth entering residential care. Polypharmacy has often been characterized as an especially serious problem in this vulnerable population. Latent Class Analysis was used to identify medication subgroups for 636 youth in an intensive residential program. Additionally, auxiliary analyses (e.g., diagnoses, demographics, expressed problem behaviors) were used to identify the personal and behavioral attributes associated with individuals in each of the latent classes. Three distinct medication patterns emerged: low/no psychotropic medication, the combination of antidepressant and antipsychotic medications, and multiple psychotropic medications. The latent classes were significantly different from one another on 12 of the 14 variables, helping explicate how patient and clinical characteristics underlie patterns of psychotropic medication use. Findings of this study, combined with additional research, hold promise for leading to improved, youth-centered prescribing practices. Our findings also highlight the need for careful monitoring of the types and range of medications that some youth are prescribed, and research on how youth with certain background characteristics are more likely to get prescribed multiple psychotropic medications. For youth experiencing higher levels of psychotropic polypharmacy, medication regimens need thoughtful reassessment using the principle of sufficiency as the foundation for medication management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Aman, M. G., Lam, K. S. L., & Van Bourgondien, M. E. (2005). Medication patterns in patients with autism: Temporal, regional, and demographic influences. Journal of Child and Adolescent Psychopharmacology, 15, 116–126. doi:10.1089/cap.2005.15.116.

    Article  PubMed  Google Scholar 

  • Anda, R. F., Brown, D. W., Felitti, V. J., Bremner, J. D., Dube, S. R., & Giles, W. H. (2007). Adverse childhood experiences and prescribed psychotropic medications in adults. American Journal of Preventive Medicine, 32, 389–394. doi:10.1016/j.amepre.2007.01.005.

    Article  PubMed  PubMed Central  Google Scholar 

  • Asparouhov, T., & Muthén, B. (2014a). Auxiliary variables in mixture modeling: Three-step approaches using Mplus. Structural Equation Modeling: A Multidisciplinary Journal, 21, 329–341.

    Article  Google Scholar 

  • Asparouhov, T., & Muthén, B. (2014b). Auxiliary variables in mixture modeling: Using the BCH method in Mplus to estimate a distal outcome model and an arbitrary secondary model. (Mplus Web Notes: No. 21).

  • Bellonci, C., & Huefner, J. C. (2014). Best medication practices within residential treatment centers for children and adolescents. In E. Caldwell, R. E. Lieberman, & G. M. Blau (Eds.), Best practices in residential: A roadmap to improve long-term outcomes (pp. xx).

  • Bennink, M., Croon, M. A., & Vermunt, J. K. (2013). Micro-macro multilevel analysis for discrete data: A latent variable approach and an application on personal network data. Sociological Methods and Research, 42, 431–457.

  • Berlin, K. S., Parra, G. R., & Williams, N. A. (2014). An introduction to latent variable mixture modeling (part 2): Longitudinal latent class growth analysis and growth mixture models. Journal of Pediatric Psychology, 39, 188–203.

    Article  PubMed  Google Scholar 

  • Brack, A. B., Huefner, J. C., & Handwerk, M. L. (2012). The impact of abuse and gender on psychopathology, behavioral disturbance, and psychotropic medication count for youth in residential treatment. American Journal of Orthopsychiatry, 82, 562–572. doi:10.1111/j.1939-0025.2012.01177.x.

    Article  Google Scholar 

  • Breland-Noble, A. M., Elbogen, E. B., Farmer, E. M. Z., Dubs, M. S., Wagner, H. R., & Burns, B. J. (2004). Use of psychotropic medications by youths in therapeutic foster care and group homes. Psychiatric Services, 55, 706–708. doi:10.1176/appi.ps.55.6.706.

    Article  PubMed  Google Scholar 

  • Brüggemann, B. R., Elgeti, H., & Ziegenbein, M. (2008). Patterns of drug prescription in a psychiatric outpatient care unit: The issue of polypharmacy. German Journal of Psychiatry, 11, 1–6.

    Google Scholar 

  • Brunner, E., Tohen, M., Osuntokun, O., Landry, J., & Thase, M. E. (2014). Efficacy and safety of olanzapine/fluoxetine combination vs fluoxetine monotherapy following successful combination therapy of treatment-resistant major depressive disorder. Neuropsychopharmacology, 39, 2549–2559. doi:10.1038/npp.2014.101.

    Article  PubMed  PubMed Central  Google Scholar 

  • Burcu, M., Zito, J. M., Safer, D. J., & Ibe, A. (2014). Psychotropic medication patterns in Medicaid-insured youth based on clinician-reported maltreatment status. Journal of Child and Family Studies, 23, 632–640. doi:10.1007/s10826-013-9713–6.

    Article  Google Scholar 

  • Carlson, G. A., Potegal, M., Margulies, D., Gutkovich, Z., & Basile, J. (2009). Rages - What are they and who has them?. Journal of Child and Adolescent Psychopharmacology, 19, 281–288. doi:10.1089/cap.2008.0108.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chamberlain, P., Price, J. M., Reid, J. B., Landsverk, J., Fisher, P. A., & Stoolmiller, M. (2006). Who disrupts from placement in foster and kinship care?. Child Abuse & Neglect, 30, 409–424.

    Article  Google Scholar 

  • Chamberlain, P., & Reid, J. B. (1987). Parent observation and report of child symptoms. Behavioral Assessment, 9, 97–109.

    Google Scholar 

  • Chena, J., Gao, K., & Kemp, D. E. (2011). Second-generation antipsychotics in major depressive disorder: Update and clinical perspective. Current Opinion in Psychiatry, 24, 10–17. doi:10.1097/YCO.0b013e3283413505.

    Article  Google Scholar 

  • Comer, J. S., Olfson, M., & Mojtabai, R. (2010). National trends in child and adolescent psychotropic polypharmacy in office-based practice, 1996–2007. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 1001–1010. doi:10.1016/j.jaac.2010.07.007.

    Article  Google Scholar 

  • Connor, D. F., Ozbayrak, K. R., Harrison, R. J., & Melloni, R. H. J. (1998). Prevalence and patterns of psychotropic and anticonvulsant medication use in children and adolescents referred to residential treatment. Journal of Child and Adolescent Psychopharmacology, 8, 27–38. doi:10.1016/S0031-9384(96)00373-3.

    Article  PubMed  Google Scholar 

  • Correll, C. U., & Carlson, H. E. (2006). Endocrine and metabolic adverse effects of psychotropic medications in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 45, 771–791. doi:10.1097/01.chi.0000220851.94392.30.

    Article  Google Scholar 

  • Daly, D. L., & Davis, J. L. (2003). Long-term residential program training manual. Boys Town, NE: Boys Town Press.

    Google Scholar 

  • Daly, D. L., Schmidt, M. D., Spellman, D. F., Criste, T. R., Dinges, K., & Teare, J. F. (1998). The Boys Town Residential Treatment Center: Treatment implementation and preliminary outcomes. Child & Youth Care Forum, 27, 267–279.

    Google Scholar 

  • Dean, A. J., McDermott, B. M., & Marshall, R. T. (2006). Psychotropic medication utilization in a child and adolescent mental health service. Journal of Child and Adolescent Psychopharmacology, 16, 273–285. doi:10.1089/cap.2006.16.273.

    Article  PubMed  Google Scholar 

  • Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., & Edwards, V. (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, 245–258.

    Article  PubMed  Google Scholar 

  • Findling, R. L., Horwit, S. M., Birmaher, B., Kowatch, R. A., Fristad, M. A., Youngstrom, E. A., & Marks, S. J. (2011). Clinical characteristics of children receiving antipsychotic medication. Journal of Child and Adolescent Psychopharmacology, 21, 311–319. doi:10.1089/cap.2010.0138.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fite, P. J., Stoppelbein, L., Greening, L., & Dhossche, D. (2008). Child internalizing and externalizing behavior as predictors of age at first admission and risk for repeat admission to a child inpatient facility. American Journal of Orthopsychiatry, 78, 63–69. doi:10.1037/0002-9432.78.1.63.

    Article  PubMed  Google Scholar 

  • Fontanella, C. A., Bridge, J. A., & Campo, J. V. (2009). Psychotropic medication changes, polypharmacy, and the risk of early readmission in suicidal adolescent inpatients. The Annals of Pharmacotherapy, 43, 1939–1947. doi:10.1345/aph.1M326.

    Article  PubMed  Google Scholar 

  • Fossett, J. W., Perloff, J. D., Kletke, P. R., & Peterson, J. A. (1992). Medicaid and access to child health care in Chicago. Journal of Health Politics, Policy and Law, 17, 273–289. doi:10.1215/03616878-17-2-273.

    Article  PubMed  Google Scholar 

  • Gadow, K. D., Brown, N. V., Arnold, L. E., Buchan-Page, K. A., Bukstein, O. G., Butter, E., & Aman, M. G. (2016). Severely aggressive children receiving stimulant medication versus stimulant and risperidone: 12-month follow-up of the TOSCA trial. Journal of the American Academy of Child & Adolescent Psychiatry, 55, 469–478. doi:10.1016/j.jaac.2016.03.014.

    Article  Google Scholar 

  • GAO. (2011). Foster children: HHS guidance could help states improve oversight of psychotropic prescriptions (GAO-12-270T). Washington, DC: U.S. Government Accountability Office.

    Google Scholar 

  • Green, T. C., Kershaw, T., Lin, H., Heimer, R., Goulet, J. L., Kraemer, K. L., & Justice, A. C. (2010). Patterns of drug use and abuse among aging adults with and without HIV: A latent class analysis of a US veteran cohort. Drug and Alcohol Dependence, 110, 208–220. doi:10.1016/j.drugalcdep.2010.02.020.

    Article  PubMed  PubMed Central  Google Scholar 

  • Griffith, A. K., Huscroft-D’Angelo, J., Epstein, M. H., Singh, N. N., Huefner, J. C., & Pick, R. (2010). Psychotropic medication use for youth in residential treatment: A comparison between youth with monopharmacy versus polypharmacy. Journal of Child and Family Studies, 19, 795–802. doi:10.1007/s10826-010-9372-9.

    Article  Google Scholar 

  • Harrison, J. N., Cluxton-Keller, F., & Gross, D. (2012). Antipsychotic medication prescribing trends in children and adolescents. Journal of Pediatric Health Care, 26, 139–145. doi:10.1016/j.pedhc.2011.10.009.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hedden, S. L., Martins, S. S., Malcolm, R. J., Floyd, L., Cavanaugh, C. E., & Latimer, W. W. (2010). Patterns of illegal drug use among an adult alcohol dependent population: Results from the National Survey on Drug Use and Health. Drug and Alcohol Dependence, 106, 119–125. doi:10.1016/j.drugalcdep.2009.08.002.

    Article  PubMed  Google Scholar 

  • Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 65–70.

    Google Scholar 

  • Huefner, J. C., Griffith, A. K., Smith, G. L., Vollmer, D. G., & Leslie, L. K. (2014). Reducing psychotropic medications in an intensive residential treatment center. Journal of Child and Family Studies, 23, 675–685. doi:10.1007/s10826-012-9628-7.

    Article  Google Scholar 

  • Huefner, J. C., & Vollmer, D. G. (2014). Characteristics and treatment needs of preadolescent versus adolescent children in an intensive residential treatment program. Residential Treatment for Children & Youth, 31, 301–315.

    Article  Google Scholar 

  • Ippen, C. G., Harris, W. W., van Horn, P., & Lieberman, A. F. (2011). Traumatic and stressful events in early childhood: Can treatment help those at highest risk? Child Abuse & Neglect, 35, 504–513. doi:10.1016/j.chiabu.2011.03.009.

    Article  Google Scholar 

  • Jann, M. W., Penzak, S. R., & Cohen, L. J. (2016). Applied clinical pharmacokinetics and pharmacodynamics of psychopharmacological agents. Cham, Switzerland: Springer.

    Book  Google Scholar 

  • Jobe-Shields, L., Parra, G. R., Williams, N. A., & Andrews, A. (2015). Person-centered approaches to understanding early family risk. Journal of Family Theory & Review.

  • Kingsbury, S. J., Yi, D., & Simpson, G. M. (2001). Rational and irrational polypharmacy. Psychiatric Services, 52, 1033–1035. doi:10.1176/appi.ps.52.8.1033.

    Article  PubMed  Google Scholar 

  • Lanza, S. T., Flaherty, B. P., & Collins, L. M. (2003). Latent class and latent transition analysis. Handbook of psychology: Research methods in psychology (pp. 663–685). Hoboken, NJ, US: John Wiley & Sons Inc. Vol. 2

    Google Scholar 

  • Larzelere, R. E. (1996). Inter-coder reliabilities and construct groupings for some important codes on the Daily Incident Report (Tech. Report No. 004–96). Boys Town, NE: Father Flanagan’s Boys’ Home.

  • Leibenluft, E. (2011). Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. The American Journal of Psychiatry, 168, 129–142. doi:10.1176/appi.ajp.2010.10050766.

    Article  PubMed  Google Scholar 

  • Leslie, L. K., Weckerly, J., Landsverk, J., Hough, R. L., Hurlburt, M. S., & Wood, P. A. (2003). Racial/ethnic differences in the use of psychotropic medication in high-risk children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 1433–1442. doi:10.1097/00004583-200312000-00010.

    Article  Google Scholar 

  • Li, Q., Xiang, Y. T., Su, Y. A., Shu, L., Yu, X., Chiu, H. F. K., & Si, T. M. (2015). Antipsychotic polypharmacy in schizophrenia patients in China and its association with treatment satisfaction and quality of life: Findings of the third national survey on use of psychotropic medications in China. Australian and New Zealand Journal of Psychiatry, 49, 129–136. doi:10.1177/0004867414536931.

    Article  PubMed  Google Scholar 

  • Linton, D., Barr, A. M., Honer, W. G., & Procyshyn, R. M. (2013). Antipsychotic and psychostimulant drug combination therapy in attention deficit/hyperactivity and disruptive behavior disorders: A systematic review of efficacy and tolerability. Current Psychiatry Reports, 15, 1–11. doi:10.1007/s11920-013-0355-6.

    Article  Google Scholar 

  • Logan, S. L., Carpenter, L., Leslie, R. S., Garrett-Mayer, E., Hunt, K. J., Charles, J., & Nicholas, J. S. (2015). Aberrant behaviors and co-occurring conditions as predictors of psychotropic polypharmacy among children with autism spectrum disorders. Journal of Child and Adolescent Psychopharmacology, 25, 323–336. doi:10.1089/cap.2013.0119.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lyons, J. S., MacIntyre, J. C., Lee, M. E., Carpinello, S., Zuber, M. P., & Fazio, M. L. (2004). Psychotropic medications prescribing patterns for children and adolescents in New York’s public mental health system. Community Mental Health Journal, 40, 101-118. doi:10.1023/B:COMH.0000022731.65054.3e.

    Article  PubMed  Google Scholar 

  • Marcus, R. N., McQuade, R. D., Carson, W. H., Hennicken, D., Fava, M., Simon, J. S., & Berman, R. M. (2008). The efficacy and safety of Aripiprazole as adjunctive therapy in major depressive disorder: A second multicenter, randomized, double-blind, placebo-controlled study. Journal of Clinical Psychopharmacology, 28, 156-165.

    Article  PubMed  Google Scholar 

  • Martin, A., Van Hoof, T., Stubbe, D., Sherwin, T., & Scahill, M. C. (2003). Multiple psychotropic pharmacotherapy among child and adolescent enrollees in Connecticut Medicaid managed care. Psychiatric Services, 54, 72–77. doi:10.1176/appi.ps.54.1.72.

    Article  PubMed  Google Scholar 

  • McIntyre, R. S., & Jerrell, J. M. (2009). Polypharmacy in children and adolescents treated for major depressive disorder: A claims database study. Journal of Clinical Psychiatry, 70, 240–246. doi:10.4088/JCP.08m04212.

    Article  PubMed  Google Scholar 

  • Mojtabai, R., & Olfson, M. (2010). National trends in psychotropic medication polypharmacy in office-based psychiatry. Archives of General Psychiatry, 67, 26–36. doi:10.1001/archgenpsychiatry.2009.175.

    Article  PubMed  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (2012). Mplus User’s Guide. Seventh Edition Los Angeles: Muthén & Muthén.

    Google Scholar 

  • Olfson, M., Crystal, S., Gerhard, T., Huang, C. S., & Carlson, G. A. (2009). Mental health treatment received by youths in the year before and after new diagnosis of bipolar disorder. Psychiatric Services, 60, 1098–1106. doi:10.1176/appi.ps.60.8.1098.

    Article  PubMed  Google Scholar 

  • Olfson, M., Crystal, S., Huang, C., & Gerhard, T. (2010). Trends in antipsychotic drug use by very young, privately insured children. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 13–23. doi:10.1097/00004583-201001000-00005.

    Google Scholar 

  • Papakostas, G. I. (2010). Switching, combination, and augmentation strategies for major depressive disorder. Annals of Clinical Psychiatry, 22, S9–S14.

    PubMed  Google Scholar 

  • Pappadopulos, E., MacIntyre, J. C., Crismon, M. L., Findling, R. L., Malone, R. P., Derivan, A., & Jensen, P. S. (2003). Treatment recommendations for the use of antipsychotics for aggressive youth (TRAAY). Part II. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 145–161. doi:10.1097/00004583-200302000-00008.

    Article  Google Scholar 

  • Patra, J., Fischer, B., Maksimowska, S., & Rehm, J. (2009). Profiling poly-substance use typologies in a multi-site cohort of illicit opioid and other drug users in Canada - A latent class analysis. Addiction Research & Theory, 17, 168–185. doi:10.1080/16066350802372827.

    Article  Google Scholar 

  • Pruitt, D. B., & Kiser, L. J. (2004). Examining pediatric multipsychotropic regimens. Behavioral Health Management, 24, S1–S4.

    Google Scholar 

  • Radigan, M., Lannon, P., Roohan, P., & Gesten, F. (2005). Medication patterns for attention-deficit/hyperactivity disorder and comorbid psychiatric conditions in a low-income population. Journal of Child and Adolescent Psychopharmacology, 15, 44–56.

    Article  PubMed  Google Scholar 

  • Raghavan, R., Brown, D. S., Allaire, B. T., Garfield, L. D., Ross, R. E., & Snowden, L. R. (2014). Racial/ethnic differences in Medicaid expenditures on psychotropic medications among maltreated children. Child Abuse & Neglect, 38, 1002–1010. doi:10.1016/j.chiabu.2014.02.013.

    Article  Google Scholar 

  • Raghavan, R., & McMillen, J. C. (2008). Use of multiple psychotropic medications among adolescents aging out of foster care. Psychiatric Services, 59, 1052–1055.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ramo, D. E., Grov, C., Delucchi, K., Kelly, B. C., & Parsons, J. T. (2010). Typology of club drug use among young adults recruited using time-space sampling. Drug and Alcohol Dependence, 107, 119–127. doi:10.1016/j.drugalcdep.2009.09.014.

    Article  PubMed  Google Scholar 

  • Rawal, P. H., Lyons, J. S., MacIntyre, II, J. C., & Hunter, J. C. (2004). Regional variation and clinical indicators of antipsychotic use in residential treatment: A four-state comparison. Journal of Behavioral Health Services & Research, 31, 178–188.

    Google Scholar 

  • Ringle, J. L., Huefner, J. C., James, S., Pick, R., & Thompson, R. W. (2012). 12-month follow-up outcomes for youth departing an integrated residential continuum of care. Children and Youth Services Review, 34, 675–679. doi:10.1016/j.childyouth.2011.12.013.

    Article  Google Scholar 

  • Rosenheck, R. (2005). The growth of psychopharmacology in the 1990s: Evidence-based practice or irrational exuberance. International Journal of Law and Psychiatry, 28, 467–483.

    Article  PubMed  Google Scholar 

  • Rubin, D., Matone, M., Huang, Y. S., dosReis, S., Feudtner, C., & Localio, R. (2012). Interstate variation in trends of psychotropic medication use among Medicaid-enrolled children in foster care. Children and Youth Services Review, 34, 1492–1499. doi:10.1016/j.childyouth.2012.04.006.

    Article  Google Scholar 

  • Ryan, J. B., Reid, R., Gallagher, K., & Ellis, C. (2008). Prevalence rates of psychotropic medications for students placed in residential facilities. Behavioral Disorders, 33, 99–107.

    Google Scholar 

  • Safer, D. J., Zito, J. M., & dosReis, S. (2003). Concomitant psychotropic medication for youths. The American Journal of Psychiatry, 160, 438–449. doi:10.1176/appi.ajp.160.3.438.

    Article  PubMed  Google Scholar 

  • Saldaña, S. N., Keeshin, B. R., Wehry, A. M., Blom, T. J., Sorter, M. T., DelBello, M. P., & Strawn, J. R. (2014). Antipsychotic polypharmacy in children and adolescents at discharge from psychiatric hospitalization. Pharmacotherapy, 34, 836–844. doi:10.1002/phar.1453.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schilling, S., & Christian, C. W. (2014). Child physical abuse and neglect. Child and Adolescent Psychiatric Clinics of North America, 23, 309–319. doi:10.1016/j.chc.2014.01.001.

    Article  PubMed  Google Scholar 

  • Singh, M. K., & Chang, K. D. (2012). The neural effects of psychotropic medications in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 21, 753–771. doi:10.1016/j.chc.2012.07.010.

    Article  PubMed  PubMed Central  Google Scholar 

  • Smith, B. D. (2005). Self-mutilation and pharmacotherapy. Psychiatry, 2, 29–37.

    Google Scholar 

  • Spellman, D. F., Griffith, A. K., Huefner, J. C., Wise, III, N., McElderry, E., & Leslie, L. K. (2010). Psychotropic medication management in a residential group care program. Child Welfare, 89, 151–167.

    PubMed  Google Scholar 

  • Stambaugh, L. F., Leslie, L. K., Ringeisen, H., Smith, K., & Hodgkin, D. (2012). Psychotropic medication use by children in child welfare. (OPRE Report #2012–33). Washington, DC: Office of Planning, Research and Evaluation, ACF, DHHS.

  • Steiner, H., & Karnik, N. S. (2009). Integrated treatment of aggression in the context of ADHD in children refractory to stimulant monotherapy: A window into the future of child psychopharmacology. The American Journal of Psychiatry, 166, 1315–1317. doi:10.1176/appi.ajp.2009.09101496.

    Article  PubMed  Google Scholar 

  • Taylor, D. (2010). Antipsychotic polypharmacy - confusion reigns. The Psychiatrist, 34, 41–43.

    Article  Google Scholar 

  • Tishler, C. L., & Reiss, N. S. (2012). Psychotropic drugs and paediatrics: A critical need for more clinical trials. Journal of Medical Ethics, 38, 250–252. doi:10.1136/medethics-2011-100003.

    Article  PubMed  Google Scholar 

  • Vitiello, B. (2005). Pharmacoepidemiology and pediatric psychopharmacology research. Journal of Child and Adolescent Psychopharmacology, 15, 10–11. doi:10.1089/cap.2005.15.10.

    Article  PubMed  Google Scholar 

  • Vitiello, B. (2007). Research in child and adolescent psychopharmacology: Recent accomplishments and new challenges. Psychopharmacology, 191, 5–13. doi:10.1007/s00213-006-0414-3.

    Article  PubMed  Google Scholar 

  • Wilens, T. E. (2009). Combined pharmacotherapy in pediatric psychopharmacology: Friend or foe?. Journal of Child and Adolescent Psychopharmacology, 19, 483–484. doi:10.1089/cap.2009.19501;10.1089/cap.2009.19501.

    Article  PubMed  Google Scholar 

  • Wright, D. J. (2001). The relationship of anxiety and externalizing disorders. Dissertation Abstracts International: Section B: The Sciences and Engineering, 62, 2084B.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Boys Town National Research Institute for Child and Family Studies, 14100 Crawford St, Boys Town, NE, 68010, USA

    Jonathan C. Huefner, Gail L. Smith, Jay L. Ringle, Amy L. Stevens & W. Alex Mason

  2. University of Nebraska, Lincoln, NE, USA

    Gilbert R. Parra

Authors
  1. Jonathan C. Huefner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gail L. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jay L. Ringle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amy L. Stevens
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W. Alex Mason
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gilbert R. Parra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonathan C. Huefner.

Ethics declarations

Conflict of interest

No external funding supported any aspect of this study. None of the authors has any conflicting interest.

Research Involving Human Participants and/or Animals

The research protocols were reviewed and approved by the organization’s internal review board (IRB) according to federal guidelines (as mentioned in the manuscript in the Procedure section).

Informed Consent

This research was based on archival data and so informed consent was not required by the IRB.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huefner, J.C., Smith, G.L., Ringle, J.L. et al. Patterns of Psychotropic Medication at Admission for Youth in Residential Care. J Child Fam Stud 26, 317–328 (2017). https://doi.org/10.1007/s10826-016-0548-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-016-0548-9

Keywords

Search

Navigation