Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Missionsstrasse 60/62, 4055, Basel, Switzerland.
Division of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University, Stromstrasse 1, 10555, Berlin, Germany.
Eur Child Adolesc Psychiatry. 2020 Sep;29(9):1207-1216. doi: 10.1007/s00787-019-01429-y. Epub 2019 Dec 12.
We investigated whether maternal psychopathology predicts offspring mental health service utilization in adolescents without mental disorders. We used weighted data (N = 2317) from NCS-A participants (age: 13-18 years) who did not meet DSM-IV criteria for any lifetime mental disorder. Adolescent mental disorders were assessed with the WHO CIDI. Maternal psychopathology was obtained by self-report. Adolescent mental health service use was assessed with the Service Assessment for Children and Adolescents. Substantial associations between maternal psychopathology and mental health service use in offspring without mental disorders were found between affective disorders and the mental health/medical specialty (hazard ratio (HR) = 2.49, 95% confidence interval (CI) = 1.60-3.90) and any service sector (HR = 2.14, CI = 1.45-3.16), anxiety disorders and any service sector (HR = 1.63, CI = 1.13-2.35), behavior disorders and the school (HR = 3.69, CI = 1.39-9.77) and any service sector (HR = 2.81, CI = 1.12-7.07), substance use disorders and the mental health/medical specialty (HR = 3.75, CI = 1.75-8.03), the school (HR = 3.17, CI = 1.43-7.02), and any service sector (HR = 3.66, CI = 2.00-6.70), and any mental disorder and the mental health/medical specialty (HR = 2.10, CI = 1.34-3.30) and any service sector (HR = 2.03, CI = 1.40-2.92). Results were comparable when restricting analyses to offspring with no indication of suicidality and no more than three life events during the past 12 months. The likelihood of service use was higher among offspring of mothers with mental disorders, compared to mothers without mental disorders. Considering maternal mental disorder status may help to identify subjects at risk of overtreatment.
我们研究了母亲的精神病理学是否能预测无精神障碍的青少年的精神健康服务利用情况。我们使用了 NCS-A 参与者（年龄：13-18 岁）的加权数据（N=2317），这些参与者不符合 DSM-IV 精神障碍的任何终身标准。青少年精神障碍使用世界卫生组织 CIDI 进行评估。母亲的精神病理学通过自我报告获得。青少年精神健康服务使用情况通过儿童和青少年服务评估进行评估。在无精神障碍的后代中，发现母亲的精神病理学与精神健康服务使用之间存在显著关联，包括情感障碍与心理健康/医学专业（危险比（HR）=2.49，95%置信区间（CI）=1.60-3.90）和任何服务部门（HR=2.14，CI=1.45-3.16），焦虑障碍与任何服务部门（HR=1.63，CI=1.13-2.35），行为障碍与学校（HR=3.69，CI=1.39-9.77）和任何服务部门（HR=2.81，CI=1.12-7.07），物质使用障碍与心理健康/医学专业（HR=3.75，CI=1.75-8.03），学校（HR=3.17，CI=1.43-7.02）和任何服务部门（HR=3.66，CI=2.00-6.70），以及任何精神障碍与心理健康/医学专业（HR=2.10，CI=1.34-3.30）和任何服务部门（HR=2.03，CI=1.40-2.92）。当将分析限制在没有自杀迹象和过去 12 个月内没有超过三个生活事件的后代时，结果是可比的。与没有精神障碍的母亲相比，有精神障碍的母亲的后代使用服务的可能性更高。考虑母亲的精神障碍状况可能有助于识别过度治疗的风险。
