McLeigh Jill D, Malthaner Lauren Q, Tovar Madeline C, Khan Mohsin
Rees-Jones Center for Foster Care Excellence, Children's Health, 1935 Medical District Drive, Mailstop ST7.03, Dallas, TX 75235 USA.
Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX USA.
J Child Adolesc Trauma. 2023 May 6;16(3):745-757. doi: 10.1007/s40653-023-00547-9. eCollection 2023 Sep.
This study sought to provide prevalence data for mental health (MH) diagnoses and psychotropic medication prescriptions among individuals in foster care and to examine their relationships with physical health status, maltreatment type, placement type, and demographic variables. Data were retrieved from electronic health records for 3,067 patients seen at integrated pediatric primary care clinics serving individuals in care. Descriptive and bivariate statistics for presence of MH diagnoses and psychotropic medication prescription were calculated. Multivariable zero-inflated negative binomial regressions were used to assess relationships. Half (50.0%) of patients had at least one MH diagnosis; trauma and stressor-related (31.5%) and attention deficit hyperactivity (22.6%) disorders were most common. 27.8% of patients were prescribed at least 1 psychotropic medication. Complex chronic physical health, having 1 and 2 or more maltreatment exposures, and being 6-11 and 12-20 years of age had significantly higher rates of having a MH diagnosis while being female, Black, Hispanic, and other race were significantly associated with lower rates. Patients with at least 1 MH diagnosis that had complex chronic physical health status, experienced sexual abuse, and were 6-11 and 12-20 years of age had significantly higher rates of psychotropic medication prescription while shelter and kinship placement and female gender were significantly associated with lower rates. Findings suggest that initial and ongoing MH screening is vital for individuals in care so that appropriate interventions can be offered. Results support implementing strategies designed to increase access to MH services for this population, such as integrated care and child psychiatry consult programs.
The online version contains supplementary material available at 10.1007/s40653-023-00547-9.
本研究旨在提供寄养儿童心理健康（MH）诊断和精神药物处方的患病率数据，并研究它们与身体健康状况、虐待类型、安置类型和人口统计学变量之间的关系。数据来自综合儿科初级保健诊所为受照料儿童诊治的3067例患者的电子健康记录。计算了MH诊断和精神药物处方的描述性和双变量统计数据。使用多变量零膨胀负二项回归来评估关系。一半（50.0%）的患者至少有一项MH诊断；创伤和应激源相关障碍（31.5%）和注意力缺陷多动障碍（22.6%）最为常见。27.8%的患者至少被开具了1种精神药物。患有复杂慢性身体健康问题、遭受1次及2次或更多次虐待、年龄在6 - 11岁和12 - 20岁的患者，MH诊断率显著更高，而女性、黑人、西班牙裔和其他种族的诊断率则显著较低。至少有一项MH诊断且患有复杂慢性身体健康问题、遭受性虐待、年龄在6 - 11岁和12 - 20岁的患者，精神药物处方率显著更高，而安置在收容所和寄养家庭以及女性性别与较低的处方率显著相关。研究结果表明，初始和持续的MH筛查对受照料儿童至关重要，以便能够提供适当的干预措施。结果支持实施旨在增加该人群获得MH服务机会的策略，如综合护理和儿童精神病学咨询项目。
在线版本包含可在10.1007/s40653 - 023 - 00547 - 9获取的补充材料。
