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. 2024 Aug;55(4):909-915.
doi: 10.1007/s10578-022-01448-y. Epub 2022 Oct 28.

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

Laura Theall  1 , Ajit Ninan  2   3 , Kim Arbeau  2 , Jessica Mannone  2 , Shannon L Stewart  4
Affiliations

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

Laura Theall et al. Child Psychiatry Hum Dev. 2024 Aug.

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.

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Conflict of interest statement

The authors have no conflict of interest to declare. Ethics clearance for secondary analyses of interRAI data gathered by other organizations was obtained from Western University (REB #106415) and all procedures have been performed in accordance with the ethical standards of Western University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Figures

Fig. 1
Fig. 1
Post-hoc investigation of the percent of nonadherent children and youth with parents with high or low stress who experienced worsening psychiatric symptoms, no change, or improvement in the previous month. Note. * p < .05; ** p < .01
Fig. 2
Fig. 2
Potential cycle of medication nonadherence and family dynamics
See this image and copyright information in PMC

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