Service Utilization for Lifetime Mental Disorders in U.S. Adolescents: Results of the National Comorbidity Survey-Adolescent Supplement (NCS-A)
Service Utilization for Lifetime Mental Disorders in U.S. Adolescents: Results of the National Comorbidity Survey-Adolescent Supplement (NCS-A)
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DOI：
10.1016/j.jaac.2010.10.006
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发表时间：
2011-01-01
影响因子：
13.3
通讯作者：
Olfson, Mark
中科院分区：
文献类型：
--
作者：
Merikangas, Kathleen Ries;He, Jian-ping;Olfson, Mark
目的：青年的心理健康政策一直受到限制的模式和相关的心理健康服务利用在这部分人口的全国代表性数据的匮乏。本次调查的目的是检查率和社会人口学相关的终身精神卫生服务使用的严重程度，类型和数量的DSM-IV障碍在全国科摩罗调查-青少年补充。方法：2002年至2004年期间，对全国有代表性的6 483名13至18岁的青少年进行了一次面对面的精神障碍调查，调查采用了世界卫生组织综合国际诊断访谈的修订版，其服务使用情况可从青少年和家长报告中获得。还评估了总的和特定部门的精神卫生服务使用情况。结果：约有三分之一的青少年精神障碍患者接受了针对其疾病的服务（36.2%）。虽然障碍的严重程度与接受治疗的可能性增加显着相关，但有一半患有严重损害性精神障碍的青少年从未因其症状接受过心理健康治疗。注意力缺陷/多动障碍（59.8%）和行为障碍（45.4%）的服务率最高，但不到五分之一的受影响青少年接受焦虑，饮食或物质使用障碍的服务。合并症和严重损害与服务利用密切相关，特别是在行为障碍的青年中。西班牙裔和非西班牙裔黑人青少年不太可能比他们的白色同行接受情绪和焦虑症的服务，即使这些疾病与严重的损害。结论：尽管公众对青年精神障碍的认识有所提高，但相当一部分患有严重精神障碍的青年人从未接受过专门的精神保健。在精神健康治疗的终生率方面存在明显的种族差异，这突出表明迫切需要确定和消除这些疾病的识别和治疗障碍。J. Am. Acad.儿童青少年精神病学，2011;50（1）：32-45.
Objective: Mental health policy for youth has been constrained by a paucity of nationally representative data concerning patterns and correlates of mental health service utilization in this segment of the population. The objectives of this investigation were to examine the rates and sociodemographic correlates of lifetime mental health service use by severity, type, and number of DSM-IV disorders in the National Comorbidity Survey-Adolescent Supplement. Method: Face-to-face survey of mental disorders from 2002 to 2004 using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview in a nationally representative sample of 6,483 adolescents 13 to 18 years old for whom information on service use was available from an adolescent and a parent report. Total and sector-specific mental health service use was also assessed. Results: Approximately one third of adolescents with mental disorders received services for their illness (36.2%). Although disorder severity was significantly associated with an increased likelihood of receiving treatment, half of adolescents with severely impairing mental disorders had never received mental health treatment for their symptoms. Service rates were highest in those with attention-deficit/hyperactivity disorder (59.8%) and behavior disorders (45.4%), but fewer than one in five affected adolescents received services for anxiety, eating, or substance use disorders. Comorbidity and severe impairment were strongly associated with service utilization, particularly in youth with behavior disorders. Hispanic and non-Hispanic Black adolescents were less likely than their White counterparts to receive services for mood and anxiety disorders, even when such disorders were associated with severe impairment. Conclusions: Despite advances in public awareness of mental disorders in youth, a substantial proportion of young people with severe mental disorders have never received specialty mental health care. Marked racial disparities in lifetime rates of mental health treatment highlight the urgent need to identify and combat barriers to the recognition and treatment of these conditions. J. Am. Acad. Child Adolesc. Psychiatry, 2011;50(1):32-45.