Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK.
Division of Informatics, Faculty of Biology, Medicine and Health, University of Manchester, UK.
Br J Psychiatry. 2021 Sep;219(3):515-522. doi: 10.1192/bjp.2021.65.
The general health of children of parents with mental illness is overlooked.
To quantify the difference in healthcare use of children exposed and unexposed to maternal mental illness (MMI).
This was a retrospective cohort study of children aged 0-17 years, from 1 April 2007 to 31 July 2017, using a primary care register (Clinical Practice Research Datalink) linked to Hospital Episodes Statistics. MMI included non-affective/affective psychosis and mood, anxiety, addiction, eating and personality disorders. Healthcare use included prescriptions, primary care and secondary care contacts; inflation adjusted costs were applied. The rate and cost was calculated and compared for children exposed and unexposed to MMI using negative binomial regression models. The total annual cost to NHS England of children with MMI was estimated.
The study included 489 255 children: 238 106 (48.7%) girls, 112 741 children (23.0%) exposed to MMI. Compared to unexposed children, exposed children had a higher rate of healthcare use (rate ratio 1.27, 95% CI 1.26-1.28), averaging 2.21 extra contacts per exposed child per year (95% CI 2.14-2.29). Increased healthcare use among exposed children occurred in inpatients (rate ratio 1.37, 95% CI 1.32-1.42), emergency care visits (rate ratio 1.34, 95% CI 1.33-1.36), outpatients (rate ratio 1.30, 95% CI 1.28-1.32), prescriptions (rate ratio 1.28, 95% CI 1.26-1.30) and primary care consultations (rate ratio 1.24, 95% CI 1.23-1.25). This costs NHS England an additional £656 million (95% CI £619-£692 million), annually.
Children of mentally ill mothers are a health vulnerable group for whom targeted intervention may create benefit for individuals, families, as well as limited NHS resources.
父母患有精神疾病的儿童的整体健康状况被忽视了。
量化暴露于和未暴露于母亲精神疾病（MMI）的儿童在医疗保健使用方面的差异。
这是一项回顾性队列研究，研究对象为 2007 年 4 月 1 日至 2017 年 7 月 31 日期间年龄在 0-17 岁的儿童，使用初级保健登记处（临床实践研究数据链接）与医院发病统计数据相关联。MMI 包括非情感/情感性精神病和心境、焦虑、成瘾、饮食和人格障碍。医疗保健的使用包括处方、初级保健和二级保健接触；应用通胀调整后的成本。使用负二项式回归模型计算并比较暴露于和未暴露于 MMI 的儿童的比率和成本。估计英格兰国民保健制度（NHS）中患有 MMI 的儿童的年度总成本。
该研究共纳入了 489255 名儿童：238106 名（48.7%）为女孩，112741 名儿童（23.0%）暴露于 MMI。与未暴露于 MMI 的儿童相比，暴露于 MMI 的儿童的医疗保健使用率更高（比率比 1.27，95%CI 1.26-1.28），平均每个暴露于 MMI 的儿童每年多 2.21 次就诊（95%CI 2.14-2.29）。暴露于 MMI 的儿童的医疗保健使用率增加发生在住院病人（比率比 1.37，95%CI 1.32-1.42）、急诊（比率比 1.34，95%CI 1.33-1.36）、门诊（比率比 1.30，95%CI 1.28-1.32）、处方（比率比 1.28，95%CI 1.26-1.30）和初级保健咨询（比率比 1.24，95%CI 1.23-1.25）。这使英格兰国民保健制度每年额外花费 6.56 亿英镑（95%CI 6.19-6.92 亿英镑）。
患有精神疾病的母亲的孩子是一个健康脆弱群体，针对他们的干预措施可能会给个人、家庭以及有限的国民保健制度资源带来好处。
