Type Of Mental Health Treatment Research Articles

Estimates of Major Depressive Disorder and Treatment Among Adolescents by Race and Ethnicity

The COVID-19 pandemic has contributed to poorer mental health and a greater need for treatment. Nationally representative estimates of major depressive disorder (MDD) and mental health treatment among US adolescents during the pandemic are needed. To estimate MDD prevalence among adolescents, evaluate mental health treatment use among adolescents with MDD, and assess differences by race and ethnicity. This cross-sectional analysis of the nationally representative 2021 National Survey on Drug Use and Health included noninstitutionalized US adolescents between the ages of 12 and 17 years (n = 10 743). Analytic weights were applied to all rates and model estimates to be nationally representative and account for sample design and survey nonresponse. Data were collected from January 14 to December 20, 2021, and analyzed from February 11 to April 3, 2023. Self-reported race and ethnicity. Dichotomous outcomes of MDD as defined by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), MDD-specific mental health treatment, any type of mental health treatment, telehealth visits, and delays in mental health treatment. The sample included 10 743 adolescents (51.1% male). Self-reported race and ethnicity included 5.1% Asian, 14.1% Black, 23.3% Latinx, 51.2% White, and 6.3% more than 1 race. Ages were evenly distributed: 34.0% aged 12 to 13 years; 33.3% aged 14 to 15 years; and 32.7% aged 16 to 17 years. Adolescents of more than 1 race or ethnicity had the highest MDD rate (26.5%). Compared with White adolescents, the lowest rates of any MDD treatment overall were found among Latinx adolescents (29.2% [95% CI, 22.2%-36.2%]) and those of more than 1 race or ethnicity (21.1% [95% CI, 11.6%-30.7%]). Similar results were found for treatment by any clinician (Latinx, 25.6% [95% CI, 18.8%-32.4%]; >1 race or ethnicity, 19.1% [95% CI, 9.7%-28.6%]), treatment by a mental health specialist (Latinx, 22.9% [95% CI, 16.9%-28.9%]; >1 race or ethnicity, 16.7% [95% CI, 7.1%-26.3%]), treatment by a nonspecialist clinician (Latinx, 7.3% [95% CI, 3.3%-11.3%]; >1 race or ethnicity, 4.8% [95% CI, 1.9%-7.7%]), and use of any psychotropic medication prescription (Latinx, 11.6% [95% CI, 7.3%-15.9%]; >1 race or ethnicity, 8.3% [95% CI, 2.8%-13.7]). Compared with White adolescents, Black adolescents had lower rates of MDD treatment by any clinician (31.7% [95% CI, 23.7%-39.8%]) and by nonspecialist clinicians (8.4% [95% CI, 3.8%-13.2%]) and experienced lower prescription rates for any psychotropic medication (12.6 [95% CI, 4.6%-20.6%]). Asian (16.0% [95% CI, 5.0%-27.2%]) and Latinx (17.8% [95% CI, 12.6%-23.0%]) adolescents had lower rates of virtual mental health treatment compared with White adolescents. Black (19.1% [95% CI, 14.1%-24.2%]) and Latinx (17.9% [95% CI, 15.0%-21.1%]) adolescents had lower rates of appointments transition to telehealth, while Black adolescents (14.1% [95% CI, 10.7%-17.4%]) experienced delays getting their prescriptions. During the first full calendar year of the pandemic, approximately 1 in 5 adolescents had MDD, and less than half of adolescents who needed treatment had any mental health treatment. Adolescents in racial and ethnic minority groups, particularly Latinx, experienced the lowest treatment rates. Federal policy should target adolescents as a whole, and minority populations in particular, to ensure equitable treatment access. Efforts should consider the social, racial, ethnic, and cultural determinants of health.

Factors associated with mental health service access among Australian community-dwelling survivors of stroke

Purpose To describe types of mental health treatment accessed by community-based stroke survivors and factors associated with access. Methods A sub-group of registrants from the Australian Stroke Clinical Registry completed a supplementary survey 2.5 years post-stroke. Self-reported information about depression/anxiety and treatment access were collected. Demographic and clinical data were obtained through linkages with registry and government data. Staged multivariable logistic regression was conducted to examine factors associated with treatment access. Results Among 623 registrants surveyed (37% female, median age 69 years), 26% self-reported a medical diagnosis of depression/anxiety at 2.5 years post-stroke. Of these, only 30% reported having accessed mental health services, mostly through government-funded Medicare schemes. Younger age (odds ratio (OR) 0.95, 95% CI 0.93, 0.98), history of mental health treatment (OR 3.38, 95% CI 1.35, 8.48), feeling socially isolated (OR 2.32, 95% CI 1.16, 4.66), self-reported medical diagnosis of depression/anxiety (OR 4.85, 95% CI 2.32, 10.14), and government-subsidised team care plan arrangement (OR 4.05, 95% CI 1.96, 8.37) were associated with receiving treatment. Conclusions Many stroke survivors have untreated depression/anxiety. Primary care practitioners should be supported in undertaking effective detection and management. Older and newly diagnosed individuals should be educated about depression/anxiety and available supports. Implications for rehabilitation Primary care providers play a pivotal role in the pathway to mental health care, and therefore should always screen for depression/anxiety and provide comprehensive assessment and referral to specialist services where necessary. Targeted psychoeducation should be provided to survivors of stroke who are older and newly diagnosed with depression/anxiety, to increase awareness about mood problems following stroke. Primary care providers should collaborate with other health professionals (e.g., through coordinating a team care arrangement plan), to address patients’ multiple and complex rehabilitation needs. Rehabilitation professionals should remain informed about current evidence-based treatments for post-stroke depression/anxiety and pathways that enable their patients to access these services.

Drop out from mental health treatment in the Saudi national mental health survey

Objectives To evaluate the patterns and potential risk factors associated with mental health treatment dropout in the Saudi National Mental Health Survey (SNMHS). Methods The SNMHS is a face-to-face community-based epidemiological survey in a nationally representative household sample of respondents aged 15–65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The sample was limited to those who had received any type of mental health treatment during the past year (n = 168). The distribution of service use and the number of visits were examined. Predictors of treatment dropout were analyzed using logistic regression models. Results Treatment drop out rate was very high overall (42.1%), with dropout occurring early (after 2 visits) in the majority of cases. Participants who were previously married or were diagnosed with a 12-month substance use disorder were significantly more likely than other participants to drop out. Those receiving care from more than three types of providers were significantly less likely than others to terminate treatment prematurely. Conclusions The rate of premature termination of treatment was high and positively associated with previously married status and substance use and inversely related to the number of different providers and number of visits.

Physical activity and sedentary behaviour counselling: Attitudes and practices of mental health professionals.

Despite recent interest in the mental health benefits of increasing physical activity (PA) and reducing sedentary behaviour (SB), little is known about PA and SB counselling provided by mental health professionals. Therefore, the aim of this study was to explore the attitudes and practices of mental health professionals in recommending more PA and less SB to their clients. Quantitative data were collected using a modified version of the Exercise in Mental Illness Questionnaire in a sample of 17 Australian mental health professionals. The collected data were reported using percentages (for categorical data) and means and standard deviations (for numerical data). Additionally, in focus group discussions, 10 mental health professionals provided in-depth information about their clinical practice, facilitators, and perceived barriers in recommending more PA and less SB. They also provided suggestions on how to potentially improve their PA and SB counselling practices. The focus groups were audio-recorded, transcribed and analysed using thematic analysis. Only 35.3% of participants have undergone formal training in recommending PA in the treatment of mental illness. Most participants (64.7%) ranked PA counselling among the top three types of mental health treatment. All participants reported recommending PA to their clients at least "occasionally", while 88% of them also provided SB counselling. However, the recommendations provided were usually not specific. The most commonly reported barriers for providing PA and SB counselling were a lack of knowledge and confidence. Participants also believed that, if they were more active themselves, they would be in a better position to recommend PA to their clients, by sharing their own experience of evidence-informed strategies designed to increase PA and reduce SB. The findings of this study indicate that mental health professionals commonly provide generic PA and SB counselling to their clients. PA and SB counselling in the mental health setting could be improved by: including training on PA and SB counselling in formal education and continued professional training for mental health professionals; implementing interventions to increase PA and reduce SB among mental health professionals themselves; and ensuring support from an exercise or PA promotion specialist as a part of a multi-disciplinary approach to mental health care.

Effects of Electroconvulsive Therapy on Short-Term Suicide Mortality in a Risk-Matched Patient Population.

Although evidence has suggested that electroconvulsive therapy (ECT) is effective in reducing suicidal ideation, research establishing the effectiveness of ECT in reducing short-term risk of death by suicide is less conclusive. This study assessed whether receipt of ECT reduced suicide mortality among patients seeking healthcare in Veterans Health Administration hospitals. Annual cohorts of patients who received ECT between 2006 and 2015 were propensity score matched with mental health patients who did not receive ECT. After matching, population averaged adjusted odds were calculated to assess the risk of suicide in the year after receipt of ECT, compared with a control group. The study population consisted of 14,810 patients in the ECT cohort and 58,369 matched controls. Matching successfully reduced clinical and demographic differences between cohorts of patients who received ECT and those who did not (asymptotic Kolmogorov-Smirnov statistic = 0.02, P > 0.99). After matching and controlling for remaining between-group differences in an adjusted logistic regression, the odds of suicide in the year after receipt of ECT were not statistically different from those of matched patients who did not receive the procedure (odds ratio = 1.31, 95% confidence interval = 0.94-1.96, P = 0.095). Patients who received ECT were at a high risk for suicide. Electroconvulsive therapy did not seem to have a greater effect on decreasing short-term risk for suicide than other types of mental health treatment provided to patients with similar baseline risk.

Gender differences and program participation among prisoners with co-occurring substance abuse and mental health disorders

We examine a nationally representative sample of state inmates with co-occurring disorders (CODs) to consider their background, and ascertain whether inmate gender is related to their access to mental health and substance abuse treatment while serving their sentence. Women prisoners were significantly more likely to be given psychotropic medications, access mental health counseling, participate in clinical and non-clinical addictions treatment options, or in fact any type of mental health treatment or substance abuse options. Thus, the findings indicate that there are significant differences for male and female prisoners with CODs and their access to treatment while serving their sentences.

Gender differences in schizophrenia: A multicentric study from three Latin-America countries

This study was aimed to explore clinical differences between women and men with schizophrenia (SZ) in Latin-America. It was conducted in public mental health centers in Bolivia, Peru and Chile.Two hundred forty-seven SZ patients participated in the study, 83 (33.6%) were women and 115 (46.6%) were Aymara. Compared to men, SZ women had slightly lower negative symptoms, reported slightly less social cognitive impairments, lower Family Relationships scores and higher Sentimental Life scores, independently of marital status, illness duration, age at illness onset and type of mental health treatment. All these differences have been replicated in the Aymara subgroup except for Sentimental Life scores. Aymara SZ women reported to be significantly less adherent into treatment compared to Aymara men. SZ women were found to have a better clinical profile and higher sentimental life scores than men. However, while SZ women reported more impaired Family Relationships compared to men, they were found to receive less psychotherapy in addition to pharmacological treatment. SZ Aymara women were also identified as a specific subgroup that may be targeted for increased observance strategies.

Poorer Physical Health is Associated With Greater Mental Health Service Utilization in a Sample of Depressed U.S. Army National Guard Soldiers.

Operation Iraqi Freedom/Operation Enduring Freedom service members returning from deployment suffer from high rates of depression and report low levels of physical functioning compared to age-adjusted norms. Treatment for depression may be limited in this group and there are few data on whether Veterans receive medication treatment versus psychotherapy. We assessed rates of depression, physical functioning, and treatment with either medication or psychotherapy among recently returning service members. Study participants were recruited from National Guard soldiers in a Midwestern state (n = 1,448). Logistic regression modeling was used to examine associations between physical health and odds of receiving different types of mental health treatment for depressed individuals (n = 299). 21% of soldiers reported significant depression and 44% of depressed service members reported poor physical health. Poorer physical health was associated with increased odds of any treatment (odds ratio: 1.27, confidence interval: 1.1-1.45) and medication treatment (odds ratio: 1.23, confidence interval: 1.08-1.40) but physical health was not associated with individual psychotherapy. Poor physical health is associated with increased likelihood of pharmacological but not individual psychotherapeutic treatment. Physical health problems may increase the need for depression care or increase contact with the medical system leading to higher levels of pharmacological treatment. Access to psychotherapy may need to be increased for Veterans with poor physical health.

Mental Health Treatment for Older Veterans Newly Diagnosed with PTSD: A National Investigation

Older veterans are the largest cohort served by the U.S. Department of Veterans Affairs (VA). The aim of this study was to examine mental health service utilization among older veterans recently diagnosed with posttraumatic stress disorder (PTSD), with an interest in sociodemographic and clinical characteristics related to receipt and type of mental health treatment. VA National administrative data set and pharmacy records. VA Healthcare System. The sample comprised 96,249 veterans aged 50+ years who received a new diagnosis of PTSD between fiscal years 2008-2011. Demographic/clinical characteristics and treatment variables (receipt of mental health treatment; number of days before first appointment; receipt of psychotherapy, medication, or combination treatment; type of medication; number of psychotherapy visits) were assessed and relations were examined using logistic, negative binomial, and Cox regressions. The majority of older veterans with newly diagnosed PTSD received at least one follow-up mental health visit. Increasing age was associated with decreased odds of receipt of any type of mental health treatment, and psychiatric comorbidities and greater number of medical appointments were associated with increased odds of treatment. Among veterans who received treatment, increased age was associated with decreased odds of receiving both psychotherapy and pharmacotherapy, decreased number of psychotherapy visits, and increased waiting times. Among older veterans recently diagnosed with PTSD in the VA healthcare system, older individuals, particularly those over 80 years old, are at risk of not receiving timely and appropriate mental health treatment, indicating targeted outreach to this population could be helpful in improving care.

Mental Health Implications in Mormon Women’s Experiences With Same-Sex Attraction

Given research suggesting that individuals in conservative religions experience conflict between religious beliefs and feelings of same-sex sexuality, this study explores the mental health impact of Mormon women who experience same-sex sexuality. Twenty-three Mormon women participated in semi-structured individual interviews about their experiences with same-sex sexuality. Interview questions asked about participants’ experiences with same-sex sexuality and the LDS Church (The Church of Jesus Christ of Latter-day Saints), how this experience affected their mental health, and what types of mental health treatment they engaged in during their process of reconciliation. Data were analyzed following phenomenological methodology. Themes included the following: experiences with mood disorders, self-worth, suicidality, treatment attempts, reparative therapy, counselor’s agenda, impact of family and community, and mental health recovery. When treating women who experience conflict, counselors should assess self-worth, suicidality, and the level of community and familial support. Referral to group counseling can support self-acceptance of same-sex sexuality through normalization. Future research should examine specific practice interventions and explore impacts of other intersecting identities.

Characteristics of U.S. Suicide Decedents in 2005–2010 Who Had Received Mental Health Treatment

To inform suicide prevention efforts in mental health treatment, the study assessed associations between recent mental health treatment, personal characteristics, and circumstances of suicide among suicide decedents. Data from 18 states reporting to the National Violent Death Reporting System between 2005 and 2010 (N=57,877 suicides) were used to compare circumstances among adult decedents receiving any or no type of mental health treatment within two months before death. Of suicide decedents, 28.5% received treatment before suicide. Several variables were associated with higher odds of receiving treatment, including death by poisoning with commonly prescribed substances (adjusted odds ratio [AOR]=3.04, 95% confidence interval [CI]=2.84-3.26), a history of suicide attempts (AOR=2.77, CI=2.64-2.90), depressed mood (AOR=1.69, CI=1.62-1.76), and nonalcoholic substance abuse or dependence (AOR=1.13, CI=1.07-1.19). For nearly a third of all suicide decedents, better mental health care might have prevented death. Efforts to reduce access to lethal doses of prescription medications seem warranted to prevent overdosing with commonly prescribed substances.

Understanding the Link Between Multiple Oppressions and Depression Among African American Women

The purpose of our study was to examine the multiple oppression experiences of sexual objectification, racism, and gendered racism as predictors of depressive symptoms among a clinical sample of low-income African American women. In addition, we examined coping with oppression via internalization (i.e., the tendency to attribute responsibility or the cause of an oppressive event to oneself) as a mediator between these three intersecting forms of oppression and depressive symptoms. Participants included 144 African American women who sought some type of mental health treatment at a U.S. southeastern, public, urban, university-affiliated hospital that attends to a primarily indigent and underserved population. The results of our mediational analysis using bootstrapping provided support for a theorized model in which coping with oppressive events via internalization mediated the links between sexual objectification and depression and between racist events and depression but not between gendered racism and depression. In addition, a unique and direct effect of racist events on depression was found. Finally, the four variables in the model accounted for 42% of variance in depression scores. The study includes implications for future research and clinical work such as exploration of other mediators and the importance of comprehensive intake assessments and multicultural/feminist coping interventions.

Unconventional Mental Health Treatment: Reexamining the Racial-Ethnic Disparity in Treatment-Seeking Behavior

The aim of this study was to examine whether a more inclusive definition of mental health treatment that incorporates unconventional treatment may partially account for the racial disparity in treatment-seeking behavior. Using 2005-2007 pooled data (N=102,749) from the National Survey on Drug Use and Health (NSDUH), logistic regression models were used to examine the relationship between race (non-Hispanic white, non-Hispanic black, and Hispanic) and the type of mental health treatment sought. Treatment types were classified as conventional care (outpatient or inpatient), psychotropic medication, or unconventional treatment. Unconventional treatment was further classified as complementary and alternative medicine or parochial care, defined as treatment that appeals to a specific religious group that is provided at no cost outside a health delivery system. Compared with whites, blacks had 53% lower odds and Hispanics had 41% lower odds of seeking any type of mental health treatment in the past year. Both blacks and Hispanics were significantly less likely to report use of any single type of conventional or unconventional mental health treatment other than parochial care. Blacks had 60% greater odds and Hispanics had 36% greater odds than whites of using parochial care only. Although blacks and Hispanics were more likely than whites to use parochial mental health treatment, accounting for use of this type of unconventional treatment did not explain the racial disparity in treatment-seeking behavior.

Psychiatric Disorders and Treatment in Low-Income Pregnant Women

This study estimated the prevalence of twenty-two 12-month and lifetime psychiatric disorders in a sample of 744 low-income pregnant women and the frequency that women with psychiatric disorders received treatment. To identify psychiatric disorders, the Diagnostic Interview Schedule (DIS) was administered to Medicaid or Medicaid-eligible pregnant women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). The sample was stratified by the rural or urban location of the WIC sites in southeastern Missouri and the city of St. Louis. Eligible women were enrolled at each site until their numbers were proportional to the racial distribution of African American and Caucasian pregnant women served there. The 12-month prevalence of one or more psychiatric disorders was 30.9%. Most common were affective disorders (13.6%), particularly major depressive disorder (8.2%) and bipolar I disorder (5.2%). Only 24.3% of those with a psychiatric disorder reported that they received treatment in the past year. Lifetime prevalence of at least one disorder was 45.6%, with affective disorders being the most frequent (23.5%). Caucasian women were more likely than African Americans to have at least one 12-month disorder, with the difference largely accounted for by nicotine dependence. Higher prevalence of lifetime disorders was also found in Caucasian women, particularly affective disorders and substance use disorders. There were no differences in the prevalence of 12-month or lifetime psychiatric disorders by the urban or rural residence of subjects. With nearly one third of pregnant women meeting criteria for a 12-month psychiatric disorder and only one fourth receiving any type of mental health treatment, comprehensive psychiatric screening during pregnancy is needed along with appropriate treatment.

Youth in Comprehensive MH Programs Improve Academically, Psychiatrically

Back to table of contents Previous article Next article Professional NewsFull AccessYouth in Comprehensive MH Programs Improve Academically, PsychiatricallyEve BenderEve BenderSearch for more papers by this authorPublished Online:3 Jul 2009https://doi.org/10.1176/pn.44.13.0008aYoung people with serious emotional problems receiving comprehensive, individualized mental health services in conjunction with schools and other community-based organizations experienced a reduction in psychiatric symptoms and an improvement in academic achievement, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA).The report, “Working Together to Help Youth Thrive in Schools and Communities,” was issued in May in conjunction with National Children's Mental Health Day and describes the impact that these comprehensive mental health services—also known as systems of care—have on young people with serious emotional problems. The report found that these improvements occurred for many youth within a year of their enrollment in these programs.According to the report, on average 11 percent of youth with mental health problems aged 14 to 18 fail to reach the next grade level, but among those involved in systems of care, only 8 percent repeated a grade.The report also revealed that youth involved in systems of care programs for a year or more reported a 62 percent decrease in suicide attempts, and 16 percent reported lower levels of depression. Slightly more than 20 percent reported reduced levels of anxiety than when they began receiving services.Data included in the analyses for this report represent up to 827 youth aged 14 to 18 who were assessed at intake, at six months, and at 12 months and who entered services from 2003 to 2008.“Improving the outlook for children with mental health challenges is a critical part of improving our health and educational systems,” said Eric Broderick, D.D.S., M.P.H., acting administrator of SAMHSA, in a press release. “These data show that systems of care can be an effective means of revitalizing the lives of young people and reducing long-term costly consequences of inaction.”The systems of care described in the report are designed to promote positive mental health outcomes for youth with mental health problems and their families together with schools and other community-based organizations. According to the report, about 65 percent of the young people assessed received at least some type of mental health treatment in school.Comprehensive mental health service plans designed for youth are highly individualized and culturally competent, according to the report.“Working Together to Help Youth Thrive in Schools and Communities” is posted at<www.samhsa.gov/children/docs/shortReport.pdf>.▪ ISSUES NewArchived

Eye movement desensitization and reprocessing in the psychological treatment of trauma‐based psychogenic non‐epileptic seizures

AbstractLittle is known about the types of mental health treatment that are most effective for psychogenic non‐epileptic seizure (PNES) patients who have high rates of comorbid post‐traumatic stress disorder (PTSD) and dissociation. Eye movement desensitization and reprocessing (EMDR) has proved to be effective in the treatment of PTSD, anxiety states, dissociative symptoms and somatoform disorders. This study, which utilized a non‐controlled qualitative multiple revelatory case design, integrates EMDR into the psychological treatment of PNES patients with confirmed trauma experiences. With EMDR targeting trauma and dissociative symptoms in three patients, PNES were extinguished in two. Those patients have remained seizure‐free for 12–18 months. Copyright © 2007 John Wiley &amp; Sons, Ltd.

Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

Mental health treatment received by primary care patients with posttraumatic stress disorder.

Posttraumatic stress disorder (PTSD) is receiving growing attention as a pervasive and impairing disorder but is still undertreated. Our purpose was to describe the characteristics of mental health treatment received by primary care patients diagnosed with PTSD. 4383 patients from 15 primary care, family practice, or internal medicine clinics were screened for anxiety symptoms using a self-report questionnaire developed for the study. Those found positive for anxiety symptoms (N = 539) were interviewed with the Structured Clinical Interview for DSM-IV. Of these patients, 197 met diagnostic criteria for PTSD and were examined in the present study regarding the rates and types of mental health treatment they were currently receiving. Data were gathered from July 1997 to May 2001. Nearly half (48%) of the patients in general medical practice with PTSD were receiving no mental health treatment at the time of intake to the study. Of those receiving treatment, psychopharmacologic interventions were most common. Few patients were receiving empirically supported psychosocial interventions. Current comorbid major depressive disorder and current comorbid panic disorder with agoraphobia were significantly associated with receiving mental health treatment (major depressive disorder, p <.10; panic disorder with agoraphobia, p <.05). The most common reason patients gave for not receiving medication was the failure of physicians to recommend such treatment, which was also among the most common reasons for not receiving psychosocial treatment. Despite the morbidity, psychosocial impairment, and distress associated with PTSD, substantial proportions of primary care patients with the disorder are going untreated or are receiving inadequate treatment. Results suggest a need for better identification and treatment of PTSD in the primary care setting.

Metropolitan-nonmetropolitan differences in amount and type of mental health treatment

This article examines the extent to which, conditional on receiving treatment, the type of care differs across metropolitan and nonmetropolitan areas. Using data from the Medical Expenditure Panel Survey (MEPS), the findings indicate that nonmetro residents who obtained mental health care (n = 2,381) have fewer mental health visits in a calendar year than their metro counterparts after adjusting for individual-level characteristics. Although observed rates of hospitalization and contact with physicians are higher in nonmetro areas than metro areas, this difference is attributable primarily to compositional differences between metro and nonmetro residents. Copyright 2003, Elsevier Science (USA). All rights reserved.

Diagnosis and treatment of psychiatric disorders in children with a schizophrenic parent

Many children of a schizophrenic parent may inherit a portion of the genetic risk factors for schizophrenia. The frequency of DSM-IV psychopathology in children of a schizophrenic parent and the frequency and type of mental health treatment accessed by these youths is not well understood. Twenty-eight adults with schizophrenia were identified and 43 of their 6–15 year old children recruited. Clinical diagnoses, based on a structured DSM-IV interview; severity of impairment, based on the Child Global Assessment Scale; and treatment histories were obtained. Seventy-four per cent of children-with-a-schizophrenic-parent met diagnostic criteria for a current Axis I psychiatric disorder. The most common diagnostic categories included attention deficit/hyperactivity disorder (40%), any anxiety disorder (23%), and any depressive disorder (12%). Psychosis was present in 9% of this childhood sample. Of those children with a psychiatric diagnosis, 47% demonstrated current moderate or severe impairment. Approximately half of the children had received mental health evaluations and 26% had experienced at least one psychiatric medication trial. Children-with-a-schizophrenic-parent have frequent, often impairing, psychiatric problems. Despite this high prevalence, mental health evaluation and treatment is of similar frequency and type to other at-risk populations. The effectiveness and appropriateness of standard treatments remain unstudied in children-with-a-schizophrenic-parent.