Research Unit for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital, Aarhus, Denmark.
Sci Rep. 2022 May 6;12(1):7412. doi: 10.1038/s41598-022-11167-y.
Multiple health complaints (MHC) is increasing among preadolescents in many countries, but their prognostic effect for individual thriving or societal resource use is scarcely studied. This makes interpreting the significance of this increase challenging. We contribute by examining whether MHC in preadolescence predicts hospital contacts in adolescence by doing a nation-wide population-based cohort-study following preadolescents from the Danish National Birth-Cohort from 2010 to 2018. 96,382 children were invited at age 11. Responses to a modified version of the Health Behaviour in School Children Symptom Checklist (headache, dizziness, stomachache, irritability, feeling nervous, difficulty in getting to sleep and feeling low) was dichotomized into MHC (≥ 2 concurrent symptoms, each with a frequency of at least weekly, yes/no). Hospital contacts were derived from Danish registers from the date of answering the questionnaire to December 31st 2018. Negative binomial regression estimated incidence rate ratios (IRRs) comparing children with MHC to children without. Analyses were further broken down by hospital sector (psychiatric/somatic) and contact type (in-patient/out-patient/emergency room). 47,365 (49.1%) responded. Mean age was 11.2 years, 52% girls. 10.3% of responders reported MHC. For hospital contacts, the unadjusted IRR was 1.74 [95% CI 1.65, 1.83]. Results were robust to adjustment for sociodemographic variables and somatic/psychiatric morbidity diagnosed before baseline, IRR 1.62 [95% CI 1.54-1.71]. In conclusion, MHC in preadolescents are prognostic of hospital contacts. This shows that we cannot ignore MHC, and to prevent potentially unhelpful healthcare use, we must act. Future research should focus on the underlying causes of MHC to understand which changes will be most helpful and thus how to act.
多种健康抱怨 (MHC) 在许多国家的青春期前儿童中日益增加，但它们对个体茁壮成长或社会资源利用的预后影响却很少被研究。这使得解释这种增加的意义具有挑战性。我们通过进行一项全国性的基于人群的队列研究来解决这个问题，该研究跟踪了丹麦全国出生队列中 2010 年至 2018 年期间的青春期前儿童。共有 96382 名儿童受邀参加研究。对健康行为在学校儿童症状检查表（头痛、头晕、腹痛、易怒、紧张、入睡困难和情绪低落）的改良版本的回答被分为 MHC（≥2 种同时出现的症状，每种症状的频率至少每周一次，是/否）。医院接触是从回答问卷之日起至 2018 年 12 月 31 日从丹麦登记处获得的。负二项回归估计了 MHC 儿童与无 MHC 儿童的发病率比（IRR）。分析进一步按医院部门（精神科/躯体科）和接触类型（住院/门诊/急诊室）进行细分。47365 人（49.1%）做出了回应。平均年龄为 11.2 岁，52%为女孩。10.3%的应答者报告有 MHC。未经调整的医院接触 IRR 为 1.74[95%CI 1.65,1.83]。结果在调整基线前诊断的社会人口统计学变量和躯体/精神疾病后仍然稳健，IRR 为 1.62[95%CI 1.54-1.71]。总之，青春期前儿童的 MHC 是医院接触的预后因素。这表明我们不能忽视 MHC，如果要防止潜在无益的医疗保健使用，我们必须采取行动。未来的研究应集中于 MHC 的根本原因，以了解哪些变化最有帮助，从而了解如何采取行动。
