Waldmann Tamara, Stiawa Maja, Dinc Ümügülsüm, Saglam Gülsah, Busmann Mareike, Daubmann Anne, Adema Bonnie, Wegscheider Karl, Wiegand-Grefe Silke, Kilian Reinhold
Department of Psychiatry and Psychotherapy II, University of Ulm and BKH Günzburg, Lindenallee 2, 89312, Günzburg, Germany.
Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Child Adolesc Psychiatry Ment Health. 2021 Feb 20;15(1):10. doi: 10.1186/s13034-021-00360-y.
Children of parents with mental illness have a higher risk of developing mental health problems when compared with the general population. Therefore, families with parents with mental illness are a suitable target group for selective prevention. In order to plan and evaluate the health economic consequences of preventive interventions for this target group, data on the societal costs related to parenthood under the condition of mental disorders are needed. To date, within Germany there has been a lack of research evaluating the costs of mental health treatment and use of social services by children and adolescents with parents with mental illness.
As part of a multicentre randomised controlled trial, use and costs of health and social services were assessed for a sample of 332 children and adolescents with parents with mental illness in six regions of Germany. Service use at baseline was assessed by the German version of the Children and Adolescent Mental Health Service Receipt Inventory. Costs were calculated for 12 months based on diagnosis and service user status and described separately. Cost drivers were identified by means of a two-part regression model.
Total mean costs for 12 months for the total sample amount of € 3736.35 (95% CI: € 2816.84-4813.83) per person. Children with a psychiatric diagnosis generated a total of € 5691.93 (95% CI: € 4146.27-7451.38) of costs per person, compared to € 1245.01 (95% CI: € 657.44-1871.49) for children without a psychiatric diagnosis. The logit part indicates significant odds ratios for individual functioning and diagnosis of the child as well as for family functioning. The linear part reveals that increasing individual functioning in the child is related to decreasing costs.
Children of families with parents with mental illness use a broad spectrum of mental health care, school-based support and youth welfare services even if they are not yet diagnosed as having a mental disorder. Further research should examine whether these institutions are sufficiently qualified and interlinked to meet the support needs of this vulnerable group. Trial registration The study was registered at the 07/10/2014 before the start of data collection (04/11/2014) at the German clinical trials register (Deutsches Register Klinischer Studien, DRKS, nr: DRKS00006806, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006806 ).
与普通人群相比，父母患有精神疾病的儿童出现心理健康问题的风险更高。因此，父母患有精神疾病的家庭是选择性预防的合适目标群体。为了规划和评估针对该目标群体的预防性干预措施的健康经济后果，需要有关精神障碍情况下与为人父母相关的社会成本的数据。迄今为止，德国国内缺乏对父母患有精神疾病的儿童和青少年的心理健康治疗成本及社会服务使用情况进行评估的研究。
作为一项多中心随机对照试验的一部分，对德国六个地区的332名父母患有精神疾病的儿童和青少年样本的健康和社会服务使用情况及成本进行了评估。基线时的服务使用情况通过德文版的儿童和青少年心理健康服务接受情况清单进行评估。根据诊断和服务使用者状况计算了12个月的成本，并分别进行了描述。通过两部分回归模型确定成本驱动因素。
整个样本每人12个月的总平均成本为3736.35欧元（95%置信区间：2816.84 - 4813.83欧元）。患有精神疾病诊断的儿童每人产生的总成本为5691.93欧元（95%置信区间：4146.27 - 7451.38欧元），而没有精神疾病诊断的儿童为1245.01欧元（95%置信区间：657.44 - 1871.49欧元）。logit部分显示了儿童个体功能和诊断以及家庭功能的显著优势比。线性部分表明，儿童个体功能的增强与成本降低相关。
父母患有精神疾病的家庭中的儿童即使尚未被诊断患有精神障碍，也会广泛使用心理健康护理、学校支持和青少年福利服务。进一步的研究应考察这些机构是否具备足够的资质以及是否相互联系以满足这一弱势群体的支持需求。试验注册 该研究于2014年7月10日在数据收集开始前（2014年11月4日）在德国临床试验注册中心（Deutsches Register Klinischer Studien，DRKS，编号：DRKS00006806，https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006806 ）进行了注册。
