Center for Health Policy and Health Services Research, Henry Ford Health System, One Ford Place-3A, Detroit, MI 48202, USA.
Soc Psychiatry Psychiatr Epidemiol. 2012 Nov;47(11):1807-14. doi: 10.1007/s00127-012-0482-0. Epub 2012 Feb 10.
To characterize the rate of comorbid psychiatric conditions (CPC) among children with autism spectrum disorders (ASD), to examine their treatment utilization, and to investigate treatment delay or non-delivery.
Lifetime ASD and CPC in children, aged 2-17, were investigated using data from the 2007-2008 National Survey of Children's Health (NSCH). The NSCH surveyed parents and guardians regarding the health and well being, including treatment, of their child(ren) under age 18 (n = 91,642). Children with health conditions were defined by parent report that a doctor or other health professional had ever said their child had that condition. Factors related to overall health, treatment utilization, and barriers to access variables were investigated among this group.
Children with ASD/CPC had poorer overall health outcomes than children with ASD alone. They more often were dissatisfied with their between-provider communication and less often had insurance cover needed services. Nonetheless, they did tend to use care coordination and mental health services to a greater degree. Families were more likely to report the delay or non-receipt of needed services when they perceived a lack of communication and partnership with providers, when they lacked insurance coverage, and when they felt that health care costs were unreasonable.
The presence of a CPC seems to shape the treatment utilization and health outcomes of children with ASD. Because of this, health professionals working with children with autism should give special attention to treatment of those with comorbid diagnoses.
描述自闭症谱系障碍(ASD)儿童共患精神疾病(CPC)的比率,研究他们的治疗利用情况,并调查治疗延迟或未提供的情况。
使用 2007-2008 年全国儿童健康调查(NSCH)的数据调查了 2-17 岁儿童的终生 ASD 和 CPC。NSCH 调查了父母和监护人,了解其 18 岁以下儿童(n=91642)的健康和福利情况,包括治疗情况。有健康状况的儿童是指父母或其他健康专业人员曾说过他们的孩子有这种状况。对该组儿童的整体健康、治疗利用和获得障碍相关因素进行了调查。
患有 ASD/CPC 的儿童的整体健康结果比仅患有 ASD 的儿童差。他们更不满意提供者之间的沟通,并且不太经常有保险覆盖所需的服务。尽管如此,他们确实倾向于更大程度地利用护理协调和心理健康服务。当家庭认为与提供者之间缺乏沟通和合作、缺乏保险覆盖以及认为医疗保健费用不合理时,他们更有可能报告延迟或未获得所需的服务。
CPC 的存在似乎影响了 ASD 儿童的治疗利用和健康结果。因此,与自闭症儿童一起工作的健康专业人员应特别关注那些患有共病诊断的儿童的治疗。