Storm M M C, Giltay E J, van Eldik W M, Palstra E C, van Duin E D A, van den Berg D, Vermeiren R R J M
LUMC Curium - Department of Child and Adolescent Psychiatry, Leiden University Medical Center, 2300 AA, Leiden, The Netherlands.
Parnassia Group, Youz, De Banjaard, The Hague, The Netherlands.
Eur Child Adolesc Psychiatry. 2025 Apr 19. doi: 10.1007/s00787-025-02718-5.
This study examined the unique role of multiple social determinants of mental health (SDOMH) associated with mental health disorders (MHD) for children with mild intellectual disability (MID), advancing understanding in a fragmented research area. Using a population-based case-control study design, four groups aged 0-17 years (M = 10.6, 35.6% female) were studied: children receiving outpatient mental health care for MHD with MID (n = 505) and without MID (n = 2767), each with a matched control group from the general population (n = 2525 and n = 13,835, respectively). Through multivariate logistic regression analyses, both MHD groups were compared to their control group and each other to examine the likelihood of a SDOMH associated with receiving mental health care for MHD in children with and without MID. Children with MID receiving mental health care showed significant differences in multiple domains compared to their control group and to children receiving mental health care without MID. They were less likely to have European-born mothers, more likely to have parents with moderate or low education levels, and tended to live in smaller, single-parent, lower-income households. Similar, though less deviant, patterns were observed for children receiving mental health care without MID compared to the general population, except for parental education. Our study highlights that SDOMH are associated with the likelihood of receiving care for MHD in children. Moreover, children with MID face disproportionate disadvantages, particularly regarding low parental education and household income. Thus, interventions should not only target the child but also their family and environmental context.
本研究探讨了与心理健康障碍(MHD)相关的多种心理健康社会决定因素(SDOMH)对轻度智力障碍(MID)儿童的独特作用,增进了对这一零散研究领域的理解。采用基于人群的病例对照研究设计,对4组0至17岁的人群(平均年龄M = 10.6岁,女性占35.6%)进行了研究:接受MHD门诊心理健康护理的MID儿童(n = 505)和无MID的儿童(n = 2767),每组均有来自普通人群的匹配对照组(分别为n = 2525和n = 13835)。通过多因素逻辑回归分析,将两个MHD组与其对照组以及彼此进行比较,以检验与有或无MID的儿童接受MHD心理健康护理相关的SDOMH的可能性。接受心理健康护理的MID儿童与对照组以及接受心理健康护理的无MID儿童相比,在多个领域存在显著差异。他们的母亲出生在欧洲的可能性较小,父母教育水平中等或较低的可能性较大,并且倾向于生活在规模较小、单亲、低收入家庭中。与普通人群相比,接受心理健康护理的无MID儿童也观察到了类似但偏差较小的模式,父母教育情况除外。我们的研究强调,SDOMH与儿童接受MHD护理的可能性相关。此外,MID儿童面临着不成比例的劣势,特别是在父母教育水平低和家庭收入方面。因此,干预措施不仅应针对儿童,还应针对其家庭和环境背景。