Beecham Jennifer
Personal Social Services Research Unit, University of Kent, Canterbury, UK; London School of Economics and Political Science, Canterbury, UK.
J Child Psychol Psychiatry. 2014 Jun;55(6):714-32. doi: 10.1111/jcpp.12216. Epub 2014 Feb 28.
Resources for supporting children and adolescents with psychiatric disorders continue to be scarce. Economics research can identify current patterns of expenditure, and help inform allocation of treatment and support resources between competing needs or uses.
The aim was to identify the costs of supporting children and adolescents, the economic impacts of childhood psychiatric disorders in adulthood and any new evidence on the cost-effectiveness of interventions. An electronic search of databases (including PubMed, Medline and Psychinfo) identified peer-reviewed journal articles published between 2005 and 2012.
Sixty-seven papers provided data on support and treatment costs now or in the future, or cost-effectiveness analyses of services. Half the articles came from the United States. Most articles focussed on autism spectrum disorder (ASD; 23 articles), attention deficit hyperactivity disorder (ADHD; n = 15), conduct disorder (CD; n = 7), and anxiety or depression (n = 8).
Only 14 studies used a cost perspective wider than health care; most included education costs (n = 11), but only five included costs to the justice system. The number of studies estimating costs to the family has increased, particularly for children with autism spectrum disorder (ASD). In the United Kingdom, support costs for children and adolescents with conduct disorder (CD) appear to be lower than for those with attention deficit hyperactivity disorder (ADHD), although for the United States, the opposite may be true. Support costs for children and adolescents with ASD may be higher than both CD and ADHD. However, there were many differences between the samples and the methods employed making comparisons between studies difficult. Outcomes in adulthood include negative impacts on (mental) health, quality of life, public sector services, employment status and income. The evidence base is improving for child and adolescent psychiatric disorders, although only one full cost-effectiveness analysis was identified since the previous review published in 2012. However, we still do not know enough about the economic implications of support and treatment for specific disorders.
用于支持患有精神疾病的儿童和青少年的资源仍然稀缺。经济学研究可以确定当前的支出模式，并有助于为在相互竞争的需求或用途之间分配治疗和支持资源提供信息。
目的是确定支持儿童和青少年的成本、儿童期精神疾病在成年期的经济影响以及干预措施成本效益的任何新证据。对数据库（包括PubMed、Medline和Psychinfo）进行电子检索，以确定2005年至2012年期间发表的同行评审期刊文章。
67篇论文提供了有关现在或未来支持和治疗成本的数据，或服务的成本效益分析。一半的文章来自美国。大多数文章聚焦于自闭症谱系障碍（ASD；23篇文章）、注意力缺陷多动障碍（ADHD；n = 15）、品行障碍（CD；n = 7）以及焦虑或抑郁（n = 8）。
只有14项研究采用了比医疗保健更广泛的成本视角；大多数研究纳入了教育成本（n = 11），但只有5项研究纳入了司法系统的成本。估计家庭成本的研究数量有所增加，尤其是对于患有自闭症谱系障碍（ASD）的儿童。在英国，患有品行障碍（CD）的儿童和青少年的支持成本似乎低于患有注意力缺陷多动障碍（ADHD）的儿童和青少年，尽管在美国情况可能相反。患有ASD的儿童和青少年的支持成本可能高于CD和ADHD两者。然而，样本和所采用的方法之间存在许多差异，使得研究之间难以进行比较。成年期的结果包括对（心理）健康、生活质量、公共部门服务、就业状况和收入的负面影响。尽管自2012年上次综述发表以来仅确定了一项完整的成本效益分析，但儿童和青少年精神疾病的证据基础正在改善。然而，我们对特定疾病支持和治疗的经济影响仍然了解不足。
