Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, 3333 Burnet Ave. MLC 4009, Cincinnati, OH 45229-3039(∗).
Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH(†).
PM R. 2013 Dec;5(12):1026-34. doi: 10.1016/j.pmrj.2013.08.589. Epub 2013 Aug 22.
To characterize utilization of mental health services and determine the ability of a behavior problem and clinical functioning assessment to predict utilization of such services within the first 6 months after moderate and severe traumatic brain injury in a large cohort of adolescents.
Multicenter cross-sectional study.
Outpatient setting of 4 tertiary pediatric hospitals, 2 tertiary general medical centers, and 1 specialized children's hospital.
Adolescents age 12-17 years (n = 132), 1-6 months after moderate-to-severe traumatic brain injury.
Logistic regression was used to determine the association of mental health service utilization with clinical functioning as assessed by the Child and Adolescent Functional Assessment Scale and behavior problems assessed by the Child Behavioral Checklist.
Mental health service utilization measured by the Service Assessment for Children and Adolescents.
Behavioral or functional impairment occurred in 37%-56%. Of the total study population, 24.2% reported receiving outpatient mental health services, 8.3% reported receiving school services, and 28.8% reported receiving any type of mental health service. Use of any (school or outpatient) mental health service was associated with borderline to impaired total Child and Adolescent Functional Assessment Scale (odds ratio 3.50 [95% confidence interval, 1.46-8.40]; P < .01) and the Child Behavioral Checklist Total Competence (odds ratio 5.08 [95% confidence interval, 2.02-12.76]; P < .01).
A large proportion of participants had unmet mental health needs. Both the Child and Adolescent Functional Assessment Scale and the Child Behavioral Checklist identified individuals who would likely benefit from mental health services in outpatient or school settings. Future research should focus on methods to ensure early identification by health care providers of adolescents with traumatic brain injury in need of mental health services.
描述精神卫生服务的利用情况，并确定行为问题和临床功能评估在青少年中度和重度创伤性脑损伤后 6 个月内预测这些服务利用的能力。
多中心横断面研究。
4 家三级儿科医院、2 家三级综合医疗中心和 1 家专门儿童医院的门诊环境。
年龄在 12-17 岁的青少年（n=132），中度至重度创伤性脑损伤后 1-6 个月。
使用逻辑回归来确定精神卫生服务利用与儿童和青少年功能评估量表评估的临床功能以及儿童行为检查表评估的行为问题之间的关联。
儿童和青少年服务评估量表测量的精神卫生服务利用情况。
37%-56%的患者出现行为或功能障碍。在总研究人群中，24.2%的患者报告接受了门诊精神卫生服务，8.3%的患者报告接受了学校服务，28.8%的患者报告接受了任何类型的精神卫生服务。使用任何（学校或门诊）精神卫生服务与儿童和青少年功能评估量表总分（比值比 3.50[95%置信区间 1.46-8.40]；P<0.01）和儿童行为检查表总分（比值比 5.08[95%置信区间 2.02-12.76]；P<0.01）之间存在边缘至受损关系。
很大一部分参与者存在未满足的精神卫生需求。儿童和青少年功能评估量表和儿童行为检查表都确定了那些可能受益于门诊或学校环境下精神卫生服务的个体。未来的研究应集中于通过医疗保健提供者早期识别需要精神卫生服务的创伤性脑损伤青少年的方法。
