Factors contributing to the utilization of adult mental health services in children and adolescents diagnosed with hyperkinetic disorder.
OBJECTIVE
To examine whether age of First diagnosis, gender, psychiatric comorbidity, and treatment modalities (pharmacotherapy or psychotherapy) at Child and Adolescent Mental Health Services (CAMHS) moderate the risk of Adult Mental Health Services (AMHS) utilization in patients diagnosed with hyperkinetic disorder at CAMHS.


METHODS
Data were derived from the Madrid Psychiatric Cumulative Register Study. The target population comprised 32,183 patients who had 3 or more visits at CAMHS. Kaplan-Meier curves were used to assess survival data. A series of logistic regression analyses were performed to study the role of age of diagnosis, gender, psychiatric comorbidity, and treatment modalities.


RESULTS
7.1% of patients presented with hyperkinetic disorder at CAMHS. Compared to preschool children, children and adolescents first diagnosed with hyperkinetic disorder at CAMHS were more likely to use AMHS. Female gender and comorbidity with affective disorders, schizophrenia, schizotypal and delusional disorders increased the risk of use of AMHS. Pharmacological or combined treatment of hyperkinetic disorder diagnosed at CAMHS was associated with increased risk of use at AMHS.


CONCLUSIONS
Older age of first diagnosis, female gender, psychiatric comorbidity, and pharmacological treatment at CAMHS are markers of risk for the transition from CAMHS to AMHS in patients with hyperkinetic disorder diagnosed at CAMHS.
Department of Psychiatry, IIS-Fundación Jiménez Díaz, Autonoma University, 28040 Madrid, Spain.
Hilario
H
Blasco-Fontecilla
Juan J
JJ
Carballo
Rebeca
R
Garcia-Nieto
Jorge
J
Lopez-Castroman
Analucia A
AA
Alegria
Ignacio
I
Basurte-Villamor
Juncal
J
Sevilla-Vicente
Rocio
R
Navarro-Jimenez
Teresa
T
Legido-Gil
Consuelo
C
Morant-Ginestar
Miguel Angel
MA
Jimenez-Arriero
Jeronimo
J
Saiz-Ruiz
Enrique
E
Baca-Garcia
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D001289:Attention Deficit Disorder with Hyperactivity; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D001523:Mental Disorders; D008605:Mental Health Services / Q000706:statistics & numerical data*