Department of Social Medicine, Aalborg University Hospital, Havrevangen 1, 9000, Aalborg, Denmark.
Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University & Aalborg University Hospital, Fredrik Bajers Vej 5, 9220, Aalborg East, Denmark.
BMC Public Health. 2021 Mar 21;21(1):557. doi: 10.1186/s12889-021-10625-y.
Parental mental health conditions have been associated with increased morbidity and use of healthcare services in offspring. Existing studies have not examined different severities of parental mental health conditions, and the impact of paternal mental health has been overlooked. We examined the association between two severities of parental mental health conditions and use of healthcare services for children during the first year of life and explored the impact of both maternal and paternal mental health conditions.
This register-based cohort study included all live-born children born in Denmark from 2000 to 2016. Information on socioeconomics, diagnoses, drug prescriptions, and healthcare contacts was extracted from nationwide public registries. Parents were grouped according to severity of mental condition based on the place of treatment of the mental health condition. Negative binominal regression analyses were performed to estimate the incidence rate ratio (IRR) of contacts to general practice (GP), out-of-hour medical service, emergency room (ER), and out- and inpatient hospital contacts during the first 12 months of the child's life.
The analyses included 964,395 children. Twenty percent of the mothers and 12 % of the fathers were identified with mental health conditions. Paternal mental health conditions were independently associated with increased risk of infant healthcare contacts (GP IRR 1.05 (CI95% 1.04-1.06) and out-of-hour IRR 1.20 (CI95% 1.18-1.22)). Risks were higher for maternal mental health conditions (GP IRR 1.18 (CI95% 1.17-1.19) and out-of-hour IRR 1.39 (CI95% 1.37-1.41)). The risks were even higher if both parents were classified with a mental health condition (GP IRR 1.25 (CI95% 1.23-1.27) and out-of-hour contacts IRR 1.49 (CI95% 1.45-1.54)), including minor mental health condition (GP IRR 1.22 (CI95% 1.21-1.24) and out-of-hour IRR 1.37 (CI95% 1.34-1.41)). This pattern was the same for all types of healthcare contacts.
Both maternal and paternal mental health conditions, including minor mental health conditions, were associated with increased utilization of healthcare services. Focus on both parents' mental health conditions (even if minor) may be warranted in service planning.
父母的心理健康状况与子女发病率和医疗服务利用度的增加有关。现有研究尚未考察父母心理健康状况的不同严重程度，也忽视了父亲心理健康的影响。我们研究了父母心理健康状况的两种严重程度与儿童生命第一年医疗服务利用度之间的关系，并探讨了母亲和父亲心理健康状况的影响。
本基于登记的队列研究纳入了 2000 年至 2016 年期间在丹麦出生的所有活产儿。从全国性公共登记处提取社会经济状况、诊断、药物处方和医疗接触信息。根据心理健康状况的治疗地点，父母根据心理健康状况的严重程度分组。采用负二项回归分析估计儿童生命的前 12 个月内普通科医生（GP）、非工作时间医疗服务、急诊室（ER）和出入院接触的就诊次数的发生率比（IRR）。
分析纳入了 964395 名儿童。20%的母亲和 12%的父亲被诊断患有心理健康状况。父亲的心理健康状况与婴儿医疗保健接触的风险增加独立相关（GP 的 IRR 为 1.05（95%CI95%1.04-1.06）和非工作时间的 IRR 为 1.20（95%CI95%1.18-1.22））。母亲的心理健康状况风险更高（GP 的 IRR 为 1.18（95%CI95%1.17-1.19）和非工作时间的 IRR 为 1.39（95%CI95%1.37-1.41））。如果父母双方都被诊断为心理健康状况（GP 的 IRR 为 1.25（95%CI95%1.23-1.27）和非工作时间接触的 IRR 为 1.49（95%CI95%1.45-1.54）），包括轻微心理健康状况（GP 的 IRR 为 1.22（95%CI95%1.21-1.24）和非工作时间的 IRR 为 1.37（95%CI95%1.34-1.41）），风险会更高。这种模式适用于所有类型的医疗保健接触。
父母的心理健康状况（包括轻微心理健康状况）与医疗服务利用率的增加有关。在服务规划中，可能需要关注父母双方的心理健康状况（即使是轻微的）。
