Structure and trends of externalizing and internalizing psychiatric symptoms and gender differences among adolescents in the US from 1991 to 2018

Askari, Melanie S.; Rutherford, Caroline; Mauro, Pia M.; Kreski, Noah T.; Keyes, Katherine M.

doi:10.1007/s00127-021-02189-4

Cited by 23 publications

(14 citation statements)

References 74 publications

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“…More than half of all mental health hospitalizations in 2019 had a primary diagnosis of anxiety or depression, consistent with the increasing prevalence of these disorders . Other observed changes may reflect changes in diagnostic definitions or coding practices.…”

Section: Discussionmentioning

confidence: 81%

“…[41][42][43][44][45][46][47] More than half of all mental health hospitalizations in 2019 had a primary diagnosis of anxiety or depression, consistent with the increasing prevalence of these disorders. 4,[48][49][50] Other observed changes may reflect changes in diagnostic definitions or coding practices. For example, we observed fewer hospitalizations for bipolar and related disorders in 2019 than in 2009, possibly due to the addition of a new depressive disorderdisruptive mood dysregulation disorder in the DSM-5-and use of this diagnosis in place of bipolar affective disorder.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric Mental Health Hospitalizations at Acute Care Hospitals in the US, 2009-2019

Arakelyan

Freyleue

Avula

et al. 2023

JAMA

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ImportanceApproximately 1 in 6 youth in the US have a mental health condition, and suicide is a leading cause of death among this population. Recent national statistics describing acute care hospitalizations for mental health conditions are lacking.ObjectivesTo describe national trends in pediatric mental health hospitalizations between 2009 and 2019, to compare utilization among mental health and non–mental health hospitalizations, and to characterize variation in utilization across hospitals.Design, Setting, and ParticipantsRetrospective analysis of the 2009, 2012, 2016, and 2019 Kids’ Inpatient Database, a nationally representative database of US acute care hospital discharges. Analysis included 4 767 840 weighted hospitalizations among children 3 to 17 years of age.ExposuresHospitalizations with primary mental health diagnoses were identified using the Child and Adolescent Mental Health Disorders Classification System, which classified mental health diagnoses into 30 mutually exclusive disorder types.Main Outcomes and MeasuresMeasures included number and proportion of hospitalizations with a primary mental health diagnosis and with attempted suicide, suicidal ideation, or self-injury; number and proportion of hospital days and interfacility transfers attributable to mental health hospitalizations; mean lengths of stay (days) and transfer rates among mental health and non–mental health hospitalizations; and variation in these measures across hospitals.ResultsOf 201 932 pediatric mental health hospitalizations in 2019, 123 342 (61.1% [95% CI, 60.3%-61.9%]) were in females, 100 038 (49.5% [95% CI, 48.3%-50.7%]) were in adolescents aged 15 to 17 years, and 103 456 (51.3% [95% CI, 48.6%-53.9%]) were covered by Medicaid. Between 2009 and 2019, the number of pediatric mental health hospitalizations increased by 25.8%, and these hospitalizations accounted for a significantly higher proportion of pediatric hospitalizations (11.5% [95% CI, 10.2%-12.8%] vs 19.8% [95% CI, 17.7%-21.9%]), hospital days (22.2% [95% CI, 19.1%-25.3%] vs 28.7% [95% CI, 24.4%-33.0%]), and interfacility transfers (36.9% [95% CI, 33.2%-40.5%] vs 49.3% [95% CI, 45.9%-52.7%]). The percentage of mental health hospitalizations with attempted suicide, suicidal ideation, or self-injury diagnoses increased significantly from 30.7% (95% CI, 28.6%-32.8%) in 2009 to 64.2% (95% CI, 62.3%-66.2%) in 2019. Length of stay and interfacility transfer rates varied significantly across hospitals. Across all years, mental health hospitalizations had significantly longer mean lengths of stay and higher transfer rates compared with non–mental health hospitalizations.Conclusions and RelevanceBetween 2009 and 2019, the number and proportion of pediatric acute care hospitalizations due to mental health diagnoses increased significantly. The majority of mental health hospitalizations in 2019 included a diagnosis of attempted suicide, suicidal ideation, or self-injury, underscoring the increasing importance of this concern.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Pediatric Mental Health Hospitalizations at Acute Care Hospitals in the US, 2009-2019

Arakelyan

Freyleue

Avula

et al. 2023

JAMA

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“…Findings from studies carried out earlier also point to the exacerbation of numerous issues among adolescents living in more deprived areas with low social capital [41]. Outcomes include worse school performance, more frequent participation in risk and anti-social behaviours, and contact with violence, as well as mental health issues [42][43][44][45].…”

Section: Discussionmentioning

confidence: 98%

Quality of life in 13-year-olds depending on health status, residential neighbourhood deprivation and social capital – results from the Polish HBSC Study 2010–2018

Mazur¹,

Kleszczewska²,

Porwit³

et al. 2023

Ann Agric Environ Med.

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Introduction and Objective.Health-related quality of life (HRQL) should be used more extensively in monitoring the health of school-aged children. The presented study aimed to evaluate trends in KIDSCREEN-10 indices, considering mean scores and the level of social inequalities. Materials and method. 3,937 children aged 13 participated in three Health Behavior in School-aged Children (HBSC) crosssectional surveys conducted in Poland between 2010-2018. Subgroups were distinguished according to gender, health status, and three social factors (family affluence, neighbourhood social capital, and local deprivation).

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“…All these brain structural and functional changes were related to poor functional and mental health outcomes later in life [ 10 , 11 , 13 ]. Therefore, it is important to determine a relationship between normative variation in parental behavior (in absence of child maltreatment) and brain structure in children’s brains in order to provide probable explanations for mental health disorder and behavioral dysfunction that may occur during late childhood or adolescence [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Parental Internalizing and Externalizing Behavior Problems on Children’s Limbic Brain Structures—An MRI Study

Albar

Sattar

2022

Brain Sciences

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Parental behavior problems have long-term effects on children’s limbic brain structures and functions. Parental behavior problems-related brain changes in children may lead to mental disorders and behavior dysfunction later in life. However, our understanding of the relationship between parental behavior and children’s brain structures is less obvious when children and adolescents are studied in a general population without mental disorders. The majority of studies on the relationship between parental behavior and adolescent brain structure have been focused on severe forms of the following parental behavior problems: (1) internalizing behavior associated with mood and anxiety disorders, and (2) externalizing behavior associated with substance use and violence. A few studies examined the effect of normative variations or subtle differences in parental behavior. Therefore, we utilized a large study—Adolescent Brain Cognitive Development (ABCD)—to determine relationships between normative variation in parental internalizing and externalizing behavior and limbic brain structures in children and adolescents without mental disorders. Quantile (median) regression models were used to compute associations between parental behavior and children’s limbic structures. We found that parental internalizing and externalizing behaviors are uniquely associated with children’s limbic structures after adjustment for biological confounders and parental socioeconomic status. Our findings indicate that normative parental behavior may have a significant early influence on limbic structures of normally developing children and adolescents. Accelerated or delayed limbic structure maturation may account for children’s and adolescents’ behavioral inadequacies and a risk of developing specific mood disorders or substance abuse problems later in life.

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Structure and trends of externalizing and internalizing psychiatric symptoms and gender differences among adolescents in the US from 1991 to 2018

Cited by 23 publications

References 74 publications

Pediatric Mental Health Hospitalizations at Acute Care Hospitals in the US, 2009-2019

Pediatric Mental Health Hospitalizations at Acute Care Hospitals in the US, 2009-2019

Quality of life in 13-year-olds depending on health status, residential neighbourhood deprivation and social capital – results from the Polish HBSC Study 2010–2018

Effects of Parental Internalizing and Externalizing Behavior Problems on Children’s Limbic Brain Structures—An MRI Study

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