[Outpatient care for child and adolescent psychiatric disorders--data from an insuree-related epidemiological study]

Abstract

The aim of the study was to examine the extent to which psychiatric disorders are documented as a diagnosis requiring treatment in children and adolescents as well as to investigate the frequency with which non-medicinal interventions are utilized. The database comprised an 18.75% random sample of insurees from the AOK statutory health insurance fund Hessen. The data allowed an examination of the care-seeking behaviour of 55,545 children and adolescents aged 0 to 18 years in the year 2006. With respect to all psychiatric diagnostic categories, a psychiatric diagnosis was documented for 19.3% of children and adolescents in 2006. 27% of children and adolescents had received more than one psychiatric diagnosis. Up to the age of 14 years, psychiatric diagnoses were more frequently documented for boys than for girls, while this pattern was reversed from the age of 15 years upwards. Typical differences in the spectrum of services received were evident depending on the psychiatric diagnosis made. Younger age groups predominantly received logopedic treatment, occupational therapy, and physiotherapy/therapeutic exercise. With increasing age, the utilization of psychiatric and psychotherapeutic services expanded. Outpatient care is primarily provided by pediatricians and general physicians followed by practice-based child and adolescent psychiatrists as well as outpatient child and adolescent psychiatric clinics. While not all diagnoses necessitate psychiatric or psychotherapeutic interventions, it may be assumed that the predominant seeking of care from pediatricians and general physicians is reflective of continued inadequate access to child and adolescent psychiatrists or other specialized facilities and professional groups.