title: Factors associated with mental health service utilization among bipolar youth.
abstract: OBJECTIVE
  This study aims to characterize patterns of mental health service utilization within a sample of bipolar youth. Demographic variables, youth bipolar characteristics, youth comorbid conditions, and parental psychopathology were examined as predictors of treatment utilization across different levels of care.
  
  
  METHODS
  A total of 293 bipolar youth (aged 7-17 years) and their parents completed a diagnostic interview, family psychiatric history measures, and an assessment of mental health service utilization. Demographic and clinical variables were measured at baseline and mental health service use was measured at the six-month follow-up.
  
  
  RESULTS
  Approximately 80% of bipolar youth attended psychosocial treatment services over the span of 6 months. Of those who attended treatment, 67% attended only outpatient services, 22% received inpatient/partial hospitalization, and 12% received residential/therapeutic school-based services. Using multinomial logistic regression, older age, female gender, and bipolar characteristics, including greater symptom severity and rapid cycling, were found to predict higher levels of care. Youth suicidal and non-suicidal self-injurious behavior, comorbid conduct disorder, and parental substance use disorders also predicted use of more restrictive treatment settings.
  
  
  CONCLUSIONS
  Results underscore the importance of assessing for and addressing suicidality, comorbid conduct disorder, and parental substance use disorders early in the treatment of bipolar youth to potentially reduce the need for more restrictive levels of care.
authors: Department of Psychiatry and Human Behavior, Brown Medical School, CAAS, Box G-BH, Providence, RI 02912, USA. christie_rizzo@brown.edu
authors: Christie J
authors: CJ
authors: Rizzo
authors: Christianne
authors: C
authors: Esposito-Smythers
authors: Lance
authors: L
authors: Swenson
authors: Boris
authors: B
authors: Birmaher
authors: Neal
authors: N
authors: Ryan
authors: Michael
authors: M
authors: Strober
authors: Laurel
authors: L
authors: Chiappetta
authors: Sylvia
authors: S
authors: Valeri
authors: Jeffrey
authors: J
authors: Hunt
authors: David
authors: D
authors: Axelson
authors: Henrietta
authors: H
authors: Leonard
authors: Martin
authors: M
authors: Keller
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008483:Medical Assistance / Q000458:organization & administration; D016347:Medical Records Systems, Computerized; D008605:Mental Health Services / Q000458:organization & administration*; D010290:Parents / Q000523:psychology; D010372:Pediatrics; D011787:Quality of Health Care