Citation

Bushroe KM, Hade EM, McCarthy TA, Bridge JA, Leonard JC. J. Pediatr. 2018; 199: 29-34.e16.

Affiliation

The Research Institute at Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Department of Pediatrics, Columbus, OH.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.jpeds.2018.03.039

PMID

29747938

Abstract

OBJECTIVES: The purpose of this study was to compare the rates of mental health diagnoses and psychotropic prescriptions pre- and posthospitalization for injury in a managed-Medicaid population. We hypothesized that children have increased rates of mental health diagnoses and psychotropic prescriptions after injury. STUDY DESIGN: We investigated children (n = 2208) ≤18 years of age treated at a pediatric trauma center from 2005 to 2015 who were enrolled in a managed-Medicaid program at hospital admission and for at least 1 healthcare visit in the preceding year. We used Poisson regression models to estimate rates of mental health diagnoses and psychotropic prescriptions that occurred in the 12 months pre- and postinjury.

RESULTS: The rate of mental health diagnoses preinjury was 95.9 per 1000 person-years, which increased to 156.7 per 1000 postinjury (rate ratio [RR] 1.63, 95% CI 1.39-1.92). Children ages 0-4 years with burns were more likely to have mental health diagnoses postinjury (race and ethnicity adjusted RR [aRR] 8.56, 95% CI 3.30-22.2). Children with head injuries were also more likely to have mental health diagnoses postinjury: ages 0-4 years (aRR 3.87, 95% CI 1.31-11.5); ages 5-9 (aRR 3.11, 95% CI 1.27-7.59); ages 10-14 (aRR 2.17, 95% CI 1.27-3.73); and ages 15-18 (aRR 5.37, 95% CI 2.12-13.6). The rate of psychotropic prescriptions preinjury was 121.7 per 1000 person-years and increased to 310.9 per 1000 postinjury (RR 2.55, 95% CI 2.26-2.89).

CONCLUSIONS: We identified increased mental health diagnoses and psychotropic prescriptions in children following hospitalization for injury.

Copyright © 2018. Published by Elsevier Inc.

Language: en

Keywords

psychiatry; trauma