Interrupting the Cycle: Association of Parental Stress and Child/Youth Psychotropic Medication Nonadherence

Laura Theall; Ajit Ninan; Kim Arbeau; Jessica Mannone; Shannon L Stewart

doi:10.1007/s10578-022-01448-y

Interrupting the Cycle: Association of Parental Stress and Child/Youth Psychotropic Medication Nonadherence

Child Psychiatry Hum Dev. 2022 Oct 28:1-7. doi: 10.1007/s10578-022-01448-y. Online ahead of print.

Authors

Laura Theall¹, Ajit Ninan^{2

3}, Kim Arbeau², Jessica Mannone², Shannon L Stewart⁴

Affiliations

¹ Applied Research & Education, Child and Parent Resource Institute, 600 Sanatorium Road, N6H 3W7, London, ON, Canada. laura.theall-honey@ontario.ca.
² Applied Research & Education, Child and Parent Resource Institute, 600 Sanatorium Road, N6H 3W7, London, ON, Canada.
³ Division of Child and Adolescent Psychiatry, Western University, Parkwood Institute Mental Health Care Building, F4-430, N6C 0A7, London, ON, Canada.
⁴ Faculty of Education, Western University, 1151 Richmond Street, N6A 3K7, London, ON, Canada.

Abstract

Efficacy of psychotropic medication depends in large part on successful adherence to prescribed regimens. This study investigated child/youth nonadherence in relation to family dynamics and informal support. The participants were 10,225 children and youth prescribed psychotropic medication and receiving services from 50 Ontario mental health agencies, assessed with the interRAI™ Child and Youth Mental Health (ChYMH) and ChYMH-Developmental Disability (ChYMH-DD) tools. Findings suggest a cycle of parental stress and child/youth medication nonadherence possibly leading to or even perpetuated by worsening psychiatric symptoms. Informal supports do not appear to moderate this cycle. While the present data cannot speak to causes of medication nonadherence in children/youth or where the cycle begins, the results are consistent with the extant literature calling for attention to parental wellbeing to support children/youth for optimal therapeutic benefits. Understanding home dynamics related to nonadherence can assist care planning that engages the family to achieve best possible child/youth outcomes.

Keywords: Children and youth; Family; InterRAI; Nonadherence; Psychotropic medication.