Skip to main content

Advertisement

Log in

Somatic and mental health service use of children and adolescents in Germany (KiGGS-study)

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Only a limited number of national surveys have investigated both somatic and mental health service use in children and adolescents. The current study aimed to assess service use in Germany as based on at least a single contact with a somatic (pediatrician, general practitioner, nonmedical practitioner) and/or mental health (psychiatrist, psychologist, youth welfare) care specialist within the last 12 months. Questionnaire responses of 6,475 children and adolescents aged 11.0–17.9 years and their parents were analyzed based on data ascertained by the German Child and Adolescent Health Survey (KiGGS) conducted between 2003 and 2006. For assessment of mental symptom loading the Strengths and Difficulties Questionnaire (SDQ) was completed by parents, thus allowing the determination of the relationship between symptom loading and service use. ANOVA and logistic regression were performed to determine help-seeking behavior overall and of different health professional groups upon inclusion of the SDQ Total Difficulties score, gender, age and socio-economic status (SES). A total of 81.9 % of all children and adolescents had used any kind of service within the past 12 months. Seventy-seven percent and 0.8 % used only the somatic and mental health services, respectively; 4.1 % had frequented both services. Amongst youths with a ‘borderline’ and ‘abnormal’ Total Difficulties score, 11.8 and 18.6 %, respectively, sought help from mental health partners. Age, SES and Total Difficulties score were predictors of any service use; the logistic regression model explained 7.6 % of the variance. Use of mental health service was significantly predicted by only age and Total Difficulties score, the respective model explained 26.2 % of the variance. The comparison of health services use on an international level is rendered difficult by national differences in health-care provision. Nevertheless, several of our findings are similar to results obtained in other nationally representative surveys.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Achenbach T, Dumenci L, Rescorla L (2003) Are American children‘s problems still getting worse? A 23-year comparison. J Abnorm Child Psychol 31(1):1–11

    Article  PubMed  Google Scholar 

  2. Canino G, Shrout P, Rubio-Stipec M, Bird H, Bravo M, Ramírez R, Chavez L, Alegría M, Bauermeister J, Hohmann A, Ribera J, García P, Martínez-Taboas A (2004) The DSM-IV rates of child and adolescent disorders in Puerto Rico. Arch Gen Psychiatry 61(1):85–93

    Article  PubMed  Google Scholar 

  3. Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60(8):837–844

    Article  PubMed  Google Scholar 

  4. Cuffe SP, Moore CG, McKeown R (2009) ADHD and health services utilization in the national health interview survey. J Atten Disord 12(4):330–340

    Article  PubMed  Google Scholar 

  5. Cunningham PJ, Freiman MP (1996) Determinants of ambulatory mental health services use for school-age children and adolescents. Health Serv Res 31(4):409–427

    CAS  PubMed Central  PubMed  Google Scholar 

  6. Elberling H, Linneberg A, Olsen EM, Goodman R, Skovgaard AM (2010) The prevalence of SDQ-measured mental health problems at age 5–7 years and identification of predictors from birth to preschool age in a Danish birth cohort: the Copenhagen Child Cohort 2000. Eur Child Adolesc Psychiatry 19(9):725–735

    Article  PubMed  Google Scholar 

  7. Elixhauser A, Machlin SR, Zodet MW, Chevarley FM, Patel N, McCormick MC, Simpson L (2002) Health care for children and youth in the United States: 2001 annual report on access, utilization, quality, and expenditures. Ambul Pediatr 2(6):419–437

    Article  PubMed  Google Scholar 

  8. Farmer E, Burns B, Phillips SD, Angold A, Costello EJ (2003) Pathways into and through mental health services for children and adolescents. Psychiatr Serv 54(1):60–66

    Article  PubMed  Google Scholar 

  9. Ford T, Goodman R, Meltzer H (2003) The British Child and Adolescent Mental Health Survey 1999: The prevalence of DSM-IV disorders. J Am Acad Child Adolesc Psychiatry 42(10):1203–1211

    Article  PubMed  Google Scholar 

  10. Ford T, Hamilton H, Goodman R, Meltzer H (2005) Service contacts among the children participating in the British Child and Adolescent Mental Health Surveys. Child Adolesc Ment Health 10(1):2–9

    Article  Google Scholar 

  11. Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38(5):581–586

    Article  CAS  PubMed  Google Scholar 

  12. Goodman R (2001) Psychometric properties of the Strengths and Difficulties Questionnaire (SDQ). J Am Acad Child Adolesc Psychiatry 40(11):1337–1345

    Article  CAS  PubMed  Google Scholar 

  13. Goodman R, Meltzer H, Bailey V (1998) Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry 7(3):125–130

    Article  CAS  PubMed  Google Scholar 

  14. Hagen B, Strauch S (2011) The J1 adolescent health check-up: analysis of data from the German KiGGS Survey. Dtsch Arztebl Int 108(11):180–186

    PubMed Central  PubMed  Google Scholar 

  15. Heiervang E, Stormark KM, Lundervold AJ, Heimann M, Goodman R, Posserud MB, Ullebø AK, Plessen KJ, Bjelland I, Lie SA, Gillberg C (2007) Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use. J Am Acad Child Adolesc Psychiatry 46(4):438–447

    Article  PubMed  Google Scholar 

  16. Hölling H, Erhart M, Ravens-Sieberer U, Schlack R (2007) Behavioural problems in children and adolescents. First results from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsbl—Gesundheitsforsch Gesundheitsschutz 50(5–6):784–793

    Article  Google Scholar 

  17. Hölling H, Kurth B-M, Rothenberger A, Becker A, Schlack R (2008) Assessing psychopathological problems of children and adolescents from 3 to 17 years in a nationwide representative sample: results of the German health interview and examination survey for children and adolescents (KiGGS). Eur Child Adolesc Psychiatry 17(Suppl 1):34–41

    Article  PubMed  Google Scholar 

  18. Jöckel K-H, Babitsch B, Bellach B-M, Bloomfield K, Hoffmeyer-Zlotnik J, Winkler J, Wolf C (1998) Messung und Quantifizierung soziodemographischer Merkmale in epidemiologischen Studien. In: Ahrens W, Bellach B-M, Jöckel K-H (eds) Messung soziodemographischer Merkmale in der Epidemiologie. RKI-Schriften 1/1998, MVV Medizin Verlag, München, pp 7–38

  19. Jung (1998) Richtlinien zur Jugendgesundheitsuntersuchung. IOP Gemeinsamer Bundesausschuss. http://www.g-ba.de/downloads/62-492-281/RL_Jugend_2008-06-19.pdf. Accessed 23 Aug 2012

  20. Kessler RC, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber MJ, He JP, Koretz D, McLaughlin KA, Petukhova M, Sampson NA, Zaslavsky AM, Merikangas KR (2012) Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry 69(4):372–380

    Article  PubMed Central  PubMed  Google Scholar 

  21. Koskelainen M, Sourander A, Kaljonen A (2000) The Strengths and Difficulties Questionnaire among Finnish school-aged children and adolescents. Eur Child Adolesc Psychiatry 9(4):277–284

    Article  CAS  PubMed  Google Scholar 

  22. Kurth BM, Kamtsiuris P, Hölling H, Schlaud M, Dölle R, Ellert U, Kahl H, Knopf H, Lange M, Mensink GB, Neuhauser H, Rosario AS, Scheidt-Nave C, Schenk L, Schlack R, Stolzenberg H, Thamm M, Thierfelder W, Wolf U (2008) The challenge of comprehensively mapping children’s health in a nation-wide health survey: design of the German KiGGS-Study. BMC Public Health 4(8):196

    Article  Google Scholar 

  23. Laitinen-Krispijn S, Van der Ende J, Wierdsma AI, Verhulst FC (1999) Predicting adolescent mental health service use in a prospective record-linkage study. J Am Acad Child Adolesc Psychiatry 38(9):1073–1080

    Article  CAS  PubMed  Google Scholar 

  24. Lampert T, Kroll LE (2009) Die Messung des sozioökonomischen Status in sozialepidemiologischen Studien. Gesundheitliche Ungleichheit 7:309–334

    Article  Google Scholar 

  25. Lehmkuhl G, Köster I, Schubert I (2009) Ambulante Versorgung kinder- und jugendpsychiatrischer Störungen—Daten einer versichertenbezogenen epidemiologischen Studie. Prax Kinderpsychol Kinderpsychiat 58(3):170–185

    Article  Google Scholar 

  26. Marcell AV, Klein JD, Fischer I, Allan MJ, Kokotailo PK (2002) Male adolescent use of health care services: where are the boys? J Adolesc Health 30(1):35–43

    Article  PubMed  Google Scholar 

  27. McCormick MC, Kass B, Elixhauser A, Thompson J, Simpson L (2000) Annual report on access to and utilization of health care for children and youth in the United States-1999. Pediatrics 105(1 Pt 3):219–230

    CAS  PubMed  Google Scholar 

  28. Merikangas K, He JP, Brody D, Fisher P, Bourdon K, Koretz D (2010) Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics 125(1):75–81

    Article  PubMed Central  PubMed  Google Scholar 

  29. Mojtabai R (2006) Serious emotional and behavioral problems and mental health contacts in American and British children and adolescents. J Am Acad Child Adolesc Psychiatry 45(10):1215–1223

    Article  PubMed  Google Scholar 

  30. Obel C, Heiervang E, Rodriguez A, Heyerdahl S, Smedje H, Sourander A, Guðmundsson ÕÓ, Clench-Aas J, Christensen E, Heian F, Mathiesen KS, Magnusson P, Njarðvik U, Koskelainen M, Ronning JA, Stormark KM, Olsen J (2004) The Strengths and Difficulties Questionnaire in the Nordic countries. Eur Child Adolesc Psychiatry 13(Suppl 2):II/32–II/39

    Google Scholar 

  31. Ravens-Sieberer U, Erhart M, Gosch A, Wille N, European KIDSCREEN Group (2008) Mental health of children and adolescents in 12 European countries-results from the European KIDSCREEN study. Clin Psychol Psychother 15(3):154–163

    Article  PubMed  Google Scholar 

  32. Ravens-Sieberer U, Kurth BM, KiGGS study group, BELLA study group (2008) The mental health module (BELLA study) within the German Health Interview and Examination Survey of Children and Adolescents (KiGGS): study design and methods. Eur Child Adolesc Psychiatry 17(Suppl 1):10–21

    Article  PubMed  Google Scholar 

  33. Roberts RE, Attkisson CC, Rosenblatt A (1998) Prevalence of psychopathology among children and adolescents. Am J Psychiatry 155(6):715–725

    CAS  PubMed  Google Scholar 

  34. Sawyer MG, Baghurst PA, Clark JJ, Graetz BW, Kosky RJ, Nurcombe B, Patton GC, Prior MR, Raphael B, Rey JM, Whaites LC, Zubrick SR (2001) The mental health of young people in Australia: key findings from the child and adolescent component of the national survey of mental health and well-being. Aust NZ J Psychiatry 35(6):806–814

    Article  CAS  Google Scholar 

  35. Schenk L, Ellert U, Neuhauser H (2007) Kinder und Jugendliche mit Migrationshintergrund. Methodische Aspekte im Kinder- und Jugendgesundheitssurvey (KiGGS). Bundesgesundheitsbl—Gesundheitsforsch-Gesundheitsschutz 50:590–599

    Article  CAS  Google Scholar 

  36. Seiffge-Krenke I, Kollmar F (1998) Discrepancies between mothers’ and fathers’ perceptions of sons’ and daughters’ problem behaviour: a longitudinal analysis of parent-adolescent agreement on internalising and externalising problem behaviour. J Child Psychol Psychiatry 39(5):687–697

    Article  CAS  PubMed  Google Scholar 

  37. Simpson GA, Bloom B, Cohen RA, Blumberg S, Bourdon KH (2005) U.S. children with emotional and behavioral difficulties: data from the 2001, 2002, and 2003 National Health Interview Surveys. Adv Data 23(360):1–13

    Google Scholar 

  38. Simpson GA, Cohen RA, Bloom B, Blumberg SJ (2009) The impact of children’s emotional and behavioural difficulties on their lives and their use of mental health services. Paediatr Perinat Epidemiol 23(5):472–481

    Article  PubMed  Google Scholar 

  39. Stein REK, Silver EJ (2003) Patterns of medical, educational, and mental health service use in a national sample of US children. Ambul Pediatr 3(2):87–92

    Article  PubMed  Google Scholar 

  40. Tolonen H, Koponen P, Aromaa A, Conti S, Graff-Iversen S, Grøtvedt L, Kanieff M, Mindell J, Natunen S, Primatesta P, Verschuren M, Viet L, Kuulasmaa K for the Feasibility of a European Health Examination Survey (FEHES) Project (2008). http://www.julkari.fi/bitstream/handle/10024/103057/2008b18.pdf?sequence=1

  41. Verhulst FC, van der Ende J (1992) Agreement between parents’ reports and adolescents’ self-reports of problem behavior. J Child Psychol Psychiatry 33(6):1011–1023

    Article  CAS  PubMed  Google Scholar 

  42. Verhulst FC, van der Ende J (1997) Factors associated with child mental health service use in the community. J Am Acad Child Adolesc Psychiatry 36(7):901–909

    Article  CAS  PubMed  Google Scholar 

  43. Winkler J, Stolzenberg H (1999) Der Sozialschichtindex im Bundes-Gesundheitssurvey. Gesundheitswesen 61(2):178–183

    Google Scholar 

  44. Woerner W, Becker A, Friedrich C, Klasen H, Goodman R, Rothenberger A (2002) Normierung und evaluation der deutschen Elternversion des Strengths and Difficulties Questionnaire (SDQ): Ergebnisse einer repräsentativen Felderhebung. Z Kinder-Jugendpsychiatr Psychother 30(2):105–112

    Article  CAS  PubMed  Google Scholar 

  45. Woerner W, Becker A, Rothenberger A (2004) Normative data and scale properties of the German parent SDQ. Eur Child Adolesc Psychiatry 13(Suppl 2):II/3–II/10

    Google Scholar 

  46. Zwaanswijk M, van der Ende J, Verhaak P, Bensing J, Verhulst F (2003) Factors associated with adolescent mental health service need and utilization. J Am Acad Child Adolesc Psychiatry 42(6):692–700

    Article  PubMed  Google Scholar 

  47. Zwaanswijk M, Verhaak P, Bensing J, van der Ende J, Verhulst F (2003) Help seeking for emotional and behavioural problems in children and adolescents. A review of recent literature. Eur Child Adolesc Psychiatry 12(4):153–161

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Johannes Hebebrand.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wölfle, S., Jost, D., Oades, R. et al. Somatic and mental health service use of children and adolescents in Germany (KiGGS-study). Eur Child Adolesc Psychiatry 23, 753–764 (2014). https://doi.org/10.1007/s00787-014-0525-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-014-0525-z

Keywords

Navigation