Breland David J, McCarty Carolyn A, Zhou Chuan, McCauley Elizabeth, Rockhill Carol, Katon Wayne, Richardson Laura P
Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA.
Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA.
Gen Hosp Psychiatry. 2014 May-Jun;36(3):296-301. doi: 10.1016/j.genhosppsych.2013.12.003. Epub 2013 Dec 10.
Evaluate determinants of mental health service use among depressed adolescents.
We assessed mental health services use over the 12 months following screening among 113 adolescents (34 males, 79 females) from an integrated healthcare system who screened positive for depression (Patient Health Questionnaire-9 score ≥11). Youth characteristics (demographics, depression severity, and co-morbidity) and parent characteristics (parent history of depression, parent-report of youth externalizing and internalizing problems) were compared among youth who had received mental health services and those who had not. Multivariate regression was used to evaluate the strongest factors associated with mental health service use.
Overall, 52% of adolescents who screened positive for depression received mental health service in the year following screening. Higher parent-reported youth internalizing problems (OR 5.37, CI 1.77-16.35), parental history of depression/anxiety (OR 4.12, CI 1.36-12.48) were significant factors associated with mental health service use. Suicidality and functional impairment were not associated with increased mental health services use.
Parental factors including recognition of the adolescent's internalizing symptoms and parental experience with depression/anxiety are strongly associated with mental health service use for depressed adolescents. This highlights the importance of educating parents about depression and developing systems to actively screen and engage youth in treatment for depression.
评估抑郁青少年使用心理健康服务的决定因素。
我们对来自一个综合医疗系统的113名青少年(34名男性,79名女性)进行了评估,这些青少年在抑郁筛查(患者健康问卷-9得分≥11)中呈阳性,我们调查了他们在筛查后12个月内使用心理健康服务的情况。比较了接受心理健康服务的青少年和未接受心理健康服务的青少年的特征(人口统计学、抑郁严重程度和共病情况)以及父母的特征(父母的抑郁病史、父母报告的青少年外化和内化问题)。采用多变量回归来评估与心理健康服务使用相关的最强因素。
总体而言,在筛查中呈阳性的青少年中,52%在筛查后的一年内接受了心理健康服务。父母报告的青少年内化问题较高(比值比5.37,可信区间1.77 - 16.35)、父母有抑郁/焦虑病史(比值比4.12,可信区间1.36 - 12.48)是与心理健康服务使用相关的重要因素。自杀倾向和功能损害与心理健康服务使用增加无关。
包括对青少年内化症状的认识以及父母的抑郁/焦虑经历在内的父母因素与抑郁青少年使用心理健康服务密切相关。这凸显了对父母进行抑郁教育以及建立系统以积极筛查并促使青少年接受抑郁治疗的重要性。