Hisle-Gorman Elizabeth, Eide Matilda, Coll Edward J, Gorman Gregory H
Department of Pediatrics, Uniformed Services University of the Health Science, 4301 Jones Bridge Road, Bethesda, MD 20814.
Mil Med. 2014 May;179(5):573-8. doi: 10.7205/MILMED-D-13-00334.
Parental deployment is associated with children's increased mental health needs. Attention Deficit Hyperactivity Disorder (ADHD) is the most common pediatric mental health diagnosis. We hypothesize children with ADHD will have increased mental health and medication needs during parental deployment.
Retrospective cohort study of children with ADHD aged 4-8 years in the Military Health System.
Of 413,665 children aged 4-8 years, 34,205 (8.3%) had ADHD and 19,123 (55.9%) of these were prescribed ADHD medications. During parental deployments, children with ADHD had a 13% increased rate of mental and behavioral health care visits (IRR 1.13 [95% CI 1.12-1.14; p < 0.00001]) and a decreased rate of medication changes (IRR 0.94 [95% CI 0.91-0.96; p < 0.00001]) compared to when parents were at home. Medication changes related to deployment varied by age; school-aged children had decreased medication events (IRR 0.88 [95% CI 0.86-0.91; p < 0.00001]) and preschool-aged children had increased medication events (IRR 1.05 [95% CI 1.02-1.10; p = .006]) during parental deployment.
During parental deployment, children with ADHD aged 4-8 years have increased mental health visits and decreased ADHD medication changes. Younger children have increased medication changes, whereas older children have decreased changes during a parent's deployment.
父母一方被派遣服役与孩子心理健康需求增加有关。注意力缺陷多动障碍（ADHD）是最常见的儿科心理健康诊断疾病。我们假设患有ADHD的儿童在父母一方被派遣服役期间心理健康和药物治疗需求会增加。
对军事医疗系统中4至8岁患有ADHD的儿童进行回顾性队列研究。
在413,665名4至8岁的儿童中，34,205名（8.3%）患有ADHD，其中19,123名（55.9%）被开具了ADHD药物。与父母在家时相比，在父母一方被派遣服役期间，患有ADHD的儿童进行心理和行为健康护理就诊的比率增加了13%（发病率比值比[IRR]为1.13[95%置信区间为1.12 - 1.14；p < 0.00001]），而药物调整率降低了（IRR为0.94[95%置信区间为0.91 - 0.96；p < 0.00001]）。与服役相关的药物调整因年龄而异；在父母一方被派遣服役期间，学龄儿童的药物调整事件减少（IRR为0.88[95%置信区间为0.86 - 0.91；p < 0.00001]），而学龄前儿童的药物调整事件增加（IRR为1.05[95%置信区间为1.02 - 1.10；p = 0.006]）。
在父母一方被派遣服役期间，4至8岁患有ADHD的儿童心理健康就诊增加，ADHD药物调整减少。年龄较小的儿童药物调整增加，而年龄较大的儿童在父母一方服役期间药物调整减少。
