Ray G Thomas, Croen Lisa A, Habel Laurel A
Division of Research, Kaiser Permanente Medical Care Program, Northern California Region, Oakland, CA 94612, USA.
Med Care. 2009 Jan;47(1):105-14. doi: 10.1097/MLR.0b013e31817e18c0.
Analyzing health conditions and medical utilization of mothers of children with attention-deficit/hyperactivity disorder (ADHD) can shed light on biologic, environmental, and psychosocial factors relating to ADHD.
To examine health conditions, health care utilization, and costs of mothers of children with ADHD in periods before the child was diagnosed.
Using automated data from Northern California Kaiser Permanente we identified mothers of children with ADHD, mothers of children without ADHD, and mothers of children with asthma. Mothers' diagnostic clusters, health care utilization, and costs were compared. Mothers of children with ADHD were compared with mothers of children without ADHD and, separately, to mothers of children with asthma.
Compared with mothers of children without ADHD, mothers of children with ADHD were more likely to be diagnosed with numerous medical and mental health problems in the 2 years after birth of their child, including depression [odds ratio (OR): 1.88], anxiety neuroses (OR: 1.64), obesity (OR: 1.70), and musculoskeletal symptoms (OR: 1.51). Results were similar for the year before delivery. Mothers of children with ADHD also had higher total health care costs per person in the year before ($1,003) and the 2 years after ($953) the birth of their child. Mothers of children with ADHD also were diagnosed with more health conditions and had higher health care costs than mothers of children with asthma.
Our findings suggest that the likelihood of being diagnosed with ADHD is related to maternal conditions and use of health services that precede the child's diagnosis. Future studies are needed to clarify whether this is due to biologic, psychosocial, or environmental factors, or a combination.
分析注意力缺陷多动障碍(ADHD)患儿母亲的健康状况和医疗利用情况,有助于揭示与ADHD相关的生物学、环境和社会心理因素。
研究ADHD患儿母亲在孩子被诊断之前的健康状况、医疗保健利用情况和费用。
利用北加利福尼亚凯撒医疗集团的自动化数据,我们确定了ADHD患儿的母亲、非ADHD患儿的母亲以及哮喘患儿的母亲。比较了母亲们的诊断类别、医疗保健利用情况和费用。将ADHD患儿的母亲与非ADHD患儿的母亲进行比较,并分别与哮喘患儿的母亲进行比较。
与非ADHD患儿的母亲相比,ADHD患儿的母亲在孩子出生后的2年内更有可能被诊断出患有多种医疗和心理健康问题,包括抑郁症[比值比(OR):1.88]、焦虑症(OR:1.64)、肥胖症(OR:1.70)和肌肉骨骼症状(OR:1.51)。分娩前一年的结果相似。ADHD患儿的母亲在孩子出生前一年(1003美元)和出生后两年(953美元)的人均医疗保健总费用也更高。与哮喘患儿的母亲相比,ADHD患儿的母亲被诊断出的健康问题更多,医疗保健费用也更高。
我们的研究结果表明,被诊断为ADHD的可能性与母亲在孩子诊断之前的健康状况和医疗服务使用情况有关。需要进一步的研究来阐明这是由于生物学、社会心理还是环境因素,或者是多种因素的综合作用。