Storch Eric A, Gregory Sean, Salloum Alison, Quast Troy
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, USA.
Northern Arizona University, Flagstaff, USA.
Child Psychiatry Hum Dev. 2018 Aug;49(4):632-642. doi: 10.1007/s10578-017-0779-z.
This study aimed to examine the impact of Hurricane Katrina exposure on medication utilization among children with pre-existing anxiety and obsessive-compulsive and related disorders (OCRDs). Medicaid claims data from 2004 to 2006 were analyzed. Children with pre-existing anxiety/OCRDs were compared as a function of those living in a Louisiana disaster area, Louisiana non-disaster area, or Texas in terms of filled prescriptions and average days medication supply. This was further examined as a function of disorder/medication type. Prescriptions filled and average days medication supply were lower for those who resided in the disaster area of Louisiana relative to non-disaster zones in Texas (but not Louisiana). Children with OCD who lived in a disaster zone in Louisiana had 16.6 fewer days supply of antidepressants relative to youth in Texas. Similarly, children with PTSD who lived in a disaster zone in Louisiana had approximately 7 fewer days supply of stimulant medication relative to those who lived in Texas. Medication utilization was reduced for those youth directly exposed to Katrina relative to children in Texas, suggesting potential service disruption. Children with OCD and PTSD may be more likely to experience treatment disruption. Following disasters, particular attention should be given to ensuring continued treatment access for youth with pre-existing anxiety and OCRDs (as well as other conditions).
本研究旨在探讨卡特里娜飓风对患有焦虑症以及强迫症和相关障碍(OCRD)的儿童用药情况的影响。分析了2004年至2006年的医疗补助索赔数据。将患有焦虑症/OCRD的儿童,按照居住在路易斯安那州灾区、路易斯安那州非灾区或德克萨斯州,在已配药处方和平均用药天数方面进行比较。并进一步按照疾病/药物类型进行分析。相对于德克萨斯州的非灾区(但不包括路易斯安那州),居住在路易斯安那州灾区的儿童的已配药处方和平均用药天数较少。居住在路易斯安那州灾区的强迫症儿童,相对于德克萨斯州的儿童,抗抑郁药的供应天数少16.6天。同样,居住在路易斯安那州灾区的创伤后应激障碍儿童,相对于居住在德克萨斯州的儿童,刺激性药物的供应天数大约少7天。相对于德克萨斯州的儿童,直接暴露于卡特里娜飓风的青少年的用药量减少,这表明可能存在服务中断情况。患有强迫症和创伤后应激障碍的儿童可能更易出现治疗中断。灾难过后,应特别关注确保患有焦虑症和OCRD(以及其他疾病)的青少年能够持续获得治疗。