Adult mental health impairment and oral health care use in the United States, Medical Expenditure Panel Survey 2017-2021.

Background: Mental illnesses can cause mental health (MH) impairments such as decreased interest and generalized fatigue. MH impairments can adversely affect oral health. The aim of this study was to investigate the associations between MH impairment, MH care, and oral health care use.

Disparities in Psychiatric Emergency Department Boarding of Children and Adolescents.

Importance: Since the COVID-19 pandemic, emergency department boarding of youth with mental health concerns has increased.

Objective: To summarize characteristics (including gender, age, race, ethnicity, insurance, diagnosis, and barriers to placement) of youth who boarded in emergency departments while awaiting inpatient psychiatric care and to test for racial, ethnic, and gender disparities in boarding lengths and inpatient admission rates after boarding. Secondarily, to assess whether statewide demand for inpatient psychiatric care correlated with individual outcomes.

Self-Pay Outpatient Mental Health Care for Children and Adolescents, by Socioeconomic Status.

Objective: Many parents struggle to find mental health care for their children, and many mental health clinicians do not accept insurance payments. The authors aimed to estimate the frequency and cost of self-pay psychotherapy and psychotropic medication management visits for youths and to determine how service use varies by family income.

Methods: A descriptive cross-sectional analysis was performed among youths ages 5-17 years in the 2018-2020 Medical Expenditure Panel Survey.

Trends in Acute Care Use for Mental Health Conditions Among Youth During the COVID-19 Pandemic.

Importance: Understanding how children's utilization of acute mental health care changed during the COVID-19 pandemic is critical for directing resources.

Objective: To examine youth acute mental health care use (emergency department [ED], boarding, and subsequent inpatient care) during the second year of the COVID-19 pandemic.

Design, Setting, And Participants: This cross-sectional analysis of national, deidentified commercial health insurance claims of youth mental health ED and hospital care took place between March 2019 and February 2022.

Adjunctive antidepressant treatment among 763 outpatients with bipolar disorder: Findings from the Bipolar CHOICE and LiTMUS trials.

Background: Adjunctive antidepressants are frequently used for bipolar depression but their clinical efficacy has been studied in few trials and little is known about how co-occurring manic symptoms affect treatment response.

Methods: Bipolar Clinical Health Outcomes Initiative in Comparative Effectiveness (N = 482) and Lithium Treatment Moderate-Dose Use Study (N = 281) were similar comparative effectiveness trials on outpatients with bipolar disorder comparing four different randomized treatment arms with adjunctive personalized guideline-based treatment for 24 weeks. Adjunctive antidepressant treatment could be used if clinically indicated and was assessed at every study visit.

Familial severe psychiatric history in bipolar disorder and correlation with disease severity and treatment response.

Background: Bipolar disorder is a heritable disorder, and we aimed to assess the impact of family history of mental disorders in first-degree relatives on the severity and course of bipolar disorder.

Methods: The Bipolar CHOICE (lithium versus quetiapine) and LiTMUS (optimized treatment with versus without lithium) comparative effectiveness studies were similar trials among bipolar disorder outpatients studying four different randomized treatment arms for 24 weeks. Patients self-reported on six severe mental disorders among first-degree relatives.

Complex polypharmacy in bipolar disorder: Side effect burden, adherence, and response predictors.

Background: Complex polypharmacy (CP) is common in bipolar disorder (BD). We assessed the associations between CP, adherence, and side effect burden, and patient traits associated with clinical improvement in relationship to CP.

Methods: We conducted a secondary analysis of 482 adult BD participants in the Bipolar CHOICE trial.

Potential Effects Of Eliminating The Individual Mandate Penalty In California.

The tax penalty for noncompliance with the Affordable Care Act's individual mandate is to be eliminated starting in 2019. We investigated the potential impact of this change on enrollees' decisions to purchase insurance and on individual-market premiums. In a survey of enrollees in the individual market in California in 2017, 19 percent reported that they would not have purchased insurance had there been no penalty.