Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3 (Entry A11), 751 22, Uppsala, Sweden.
Eur Child Adolesc Psychiatry. 2019 Jan;28(1):43-56. doi: 10.1007/s00787-018-1185-1. Epub 2018 Jun 20.
Despite Sweden's good child health statistics, data on the mental health and wellbeing of Swedish preschool children is scarce and not routinely collected in healthcare. The study aimed to: identify the proportion of preschool children with mental health and somatic problems, the public sector services used by these children and whether they differ by type of problems, investigate whether other factors affect service use, and estimate the costs associated with these services. This study used cross-sectional data on a sample of 3175 children aged 3-5 from the "Children and Parents in Focus trial". Data on service use, child health and demographics were obtained from primary caregivers. Child mental health was assessed by both primary caregivers and teachers. 8.9% of the sample reported mental health problems, and approximately 1% had comorbid somatic and mental health problems. Over 50% of the preschoolers used any service, with school assistant being the most frequently used. The average annual cost per child, regardless of health status, was US$921, with 75% of the costs accruing at school. The presence of both somatic and mental health problems predicted higher service use, in particular extra services used at school and at home (mean annual cost US$13826 and US$1583, respectively). Children with comorbid problems accounted for the highest mean costs. Mental health problems among preschool children were particularly high compared to studies from other countries. There is a need to strengthen school mental health services to engage in proactive early identification of children with mental health problems so that appropriate care is provided.Trial registration number: ISRCTN16513449. Registered 23 July 2013.
尽管瑞典的儿童健康数据良好，但有关瑞典学龄前儿童心理健康和幸福感的数据却很匮乏，并且在医疗保健中也没有常规收集。本研究旨在：确定有心理健康和躯体问题的学龄前儿童的比例、这些儿童使用的公共部门服务以及这些服务是否因问题类型而异、调查是否有其他因素影响服务的使用，以及估计与这些服务相关的成本。本研究使用了来自“儿童与家长焦点试验”的 3175 名 3-5 岁儿童样本的横断面数据。服务使用、儿童健康和人口统计学数据是从主要照顾者那里获得的。儿童心理健康状况由主要照顾者和教师进行评估。样本中有 8.9%的儿童报告存在心理健康问题，约有 1%的儿童同时存在躯体和心理健康问题。超过 50%的学龄前儿童使用了任何服务，其中学校助理的使用最为频繁。无论健康状况如何，每个孩子的年平均成本为 921 美元，其中 75%的成本发生在学校。同时存在躯体和心理健康问题会预测更高的服务使用，特别是在学校和家庭中使用额外的服务（年平均成本分别为 13826 美元和 1583 美元）。患有共病的儿童的平均费用最高。与来自其他国家的研究相比，学龄前儿童的心理健康问题尤其高。需要加强学校心理健康服务，主动识别有心理健康问题的儿童，以便提供适当的护理。试验注册号：ISRCTN62325352。于 2013 年 7 月 23 日注册。
