Abstract
This study examined changes in the prevalence of psychiatric diagnoses at admission among children and adolescents treated for mental health problems in psychiatric inpatient settings between 1995 and 2000. Using a large, nationwide database (MarketScan) of private health insurance claims, our sample consisted of 5,346 children under the age of 18 who received psychiatric inpatient services, out of a total of 1,723,681 covered children. Odds ratios were used to measure changes in the prevalence of specific mental health disorders between 1995 and 2000. The study identified several significant changes, most notably, that the proportion of hospitalized children treated for bipolar or eating disorder doubled between 1995 and 2000. Significant decreases were observed for adjustment, anxiety, oppositional, and substance abuse disorders. This study lends support to recent concerns that the prevalence of bipolar disorder among the youth is increasing. Further research is needed to identify the underlying reasons for these observed changes.
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References
Center for Mental Health Services (1999) Annual report to congress on the evaluation of the Comprehensive Community Mental Health Services for Children and their Families Program, 1999. ORC Macro, Atlanta
Chabra A, Chavez FG, Harris SA et al (1999) Hospitalization for mental illness in adolescents. Risk groups and impact on the health care system. J Adolesc Health 24:349–356
Costello EJ (1999) Commentary on prevalence and impact of parent reported disabling mental health conditions among US children. J Am Acad Child Adolesc Psych 38:610–613
DeVane CL, Sallee FR (2002) Serotonin selective reuptake inhibitors in child and adolescent psychopharmacology: a review of published experience. J Clin Psychiatry 57:55–66
Fairburn CG, Beglin SJ (1990) Studies on the epidemiology of bulimia nervosa. Am J Psychiatry 147:401–408
Garland AF, Lough RL, McCabe KM et al (2001) Prevalence of psychiatric disorders in youths across five sectors of care. J Am Acad Child Adolesc Psych 40:409–418
Garrison ZC, Waller LJ, Cuffe PS et al (1997) Incidence of major depressive disorder and dysthymia in young adolescents. J Am Acad Child Adolesc Psych 36:458–466
Goldman W, McCulloch J, Sturm R (1998) Cost and use of mental health services before and after manage care. Health Aff (Millwood) 17:40–52
Gotestam KG, Eriksen L, Heggestad T et al (1998) Prevalence of eating disorders in Norwegian general hospitals 1990–1994: admission per year and seasonality. Int J Eat Disord 23:57–64
Harpaz-Rotem I, Rosenheck RA (2004) Changes in outpatient psychiatric diagnosis in children and adolescents 1995 to 2000. Child Psychiatry Hum Dev 34:329–340
Harris EC, Barraclough B (1998) Excess mortality of mental disorder. Br J Psychiatry 173:11–53
Kazdin AE (1989) Hospitalization of antisocial children: clinical course, follow-up status and predictors of outcome. Adv Behav Res Ther 11:1–67
Keel PK, Dorer D, Eddy KT et al (2003) Predictors of mortality in eating disorders. Arch Gen Psychiatry 60:179–183
Kim YE, Miklowitz JD (2002) Childhood mania, attention deficit hyperactivity disorder and conduct disorder: a critical review of diagnostic dilemmas. J Bipolar Disord 4:215–225
Kolteck M, Wilkes TC, Atkinson M (1998) The prevalence of posttraumatic stress disorder in an adolescent inpatient unit. Can J Psychiatry 43:64–68
Leslie LD, Rosenheck AR, Horwitz MS (2001) Patterns of mental health utilization and costs among children in a privately insured population. Health Serv Res 36:113–127
MacLeod RJ, McNamee JE, Boyle MH et al (1999) Identification of childhood psychiatric disorder by informant: comparison of clinic and community samples. Can J Psychiatry 44:144–151
Martin A, Young C, Leckman JF et al (2004) Age effects on antidepressant-induced manic conversion. Arch Pediatr Adolesc Med 158:773–780
McCllum K (1993) Eating disorders. Curr Opin Psychiatry 6:480–485
NIDA (1998) Drug use eases among teens for second consecutive year. NIDA Media Advisory, December 18, 1998
Pine SD (2002) Treating children and adolescents with selective serotonin reuptake inhibitors: how long is appropriate? J Child Adolesc Psychopharmacol 12:189–203
President’s New Freedom Commission on Mental Health (2003) Achieving the promise: transforming mental health care in America. Final report. DHHS Publ. No. SMA-03–3832, Rockville, MD
Pyle R, Neuman PA, Halvorsen PA et al (1991) An ongoing cross-sectional study of the prevalence of eating disorders in freshman college students. Int J Eat Disord 19:53–61
Rabinowitz J, Bromet EJ, Levelle J et al (1998) Prevalence and severity of substance use disorders and onset of psychosis in first-admission psychotic patients. Psychol Med 28:1411–1419
Rice JB, Woolston J, Stewart E et al (2002) Differences in younger, middle, and older children admitted to child psychiatric inpatient services. Child Psychiatry Hum Dev 32:241–261
Rushton LJ, Clark JS, Freed LG (2000) Pediatrician and family physician prescription of selective serotonin reuptake inhibitors. Pediatrics 105:1–6
Shaffer D, Fisher P, Dulcan MK et al (1996) The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): description, acceptability, prevalence rate and performance in the MECA study. J Am Acad Child Adolesc Psych 35:865–877
Soutullo AC, DelBello PM, Ochsner EJ et al (2002) Severity of bipolar in hospitalized manic adolescents with history of stimulant or antidepressant treatment. J Affect Disord 70:323–327
Surgeon General’s Report (1999) Mental health: a report of the surgeon general. U.S. Department of Health and Human Services, Office of the Surgeon General, SAMHSA, Rockville
Walkup J, Labellarte M (2001) Complication of SSRI treatment. J Child Adolesc Psychopharmacol 11:1–4
Willi J, Grossmann S (1983) Epidemiology of anorexia nervosa in a defined region of Switzerland. Am J Psychiatry 140:564–567
Zickler P (2002) Teen drug use declined in 2002. NIDA Notes 2002, vol. 17, no. 5
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Harpaz-Rotem, I., Leslie, D.L., Martin, A. et al. Changes in child and adolescent inpatient psychiatric admission diagnoses between 1995 and 2000. Soc Psychiat Epidemiol 40, 642–647 (2005). https://doi.org/10.1007/s00127-005-0923-0
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DOI: https://doi.org/10.1007/s00127-005-0923-0