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Hospital Care for Mental Health and Substance Abuse in Children with Epilepsy

Identifieur interne : 000329 ( Main/Exploration ); précédent : 000328; suivant : 000330

Hospital Care for Mental Health and Substance Abuse in Children with Epilepsy

Auteurs : Dylan P. Thibault ; Adys Mendizabal ; Nicholas S. Abend ; Kathryn A. Davis ; James Crispo [Canada] ; Allison. W. Willis

Source :

RBID : PMC:5347535

Abstract

Background

Reducing the burden of pediatric mental illness requires greater knowledge of Mental Health and Substance Abuse (MHSA) outcomes in children who are at an increased risk of primary psychiatric illness. National data on hospital care for psychiatric illness in children with epilepsy are limited.

Methods

We used the Kids’ Inpatient Database (KID), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality, from 2003-2009 to examine MHSA hospitalization patterns in children with comorbid epilepsy. Non-parametric and regression analyses determined the association of comorbid epilepsy with specific MHSA diagnoses and examined the impact of epilepsy on length of stay (LOS) for such MHSA diagnoses while controlling for demographic, payer and hospital characteristics.

Results

We observed 353,319 weighted MHSA hospitalizations of children ages 6 - 20; 3,280 of these involved a child with epilepsy. Depression was the most common MHSA diagnosis in the general population (39.5%) whereas bipolar disorder was the most common MHSA diagnosis among children with epilepsy (36.2%). Multivariate logistic regression models revealed that children with comorbid epilepsy had greater adjusted odds of bipolar disorder (AOR 1.17, 1.04-1.30), psychosis (AOR 1.78, 1.51-2.09), sleep disorder (AOR 5.90, 1.90-18.34), and suicide attempt/ ideation (AOR 3.20, 1.46-6.99) compared to the general MHSA inpatient population. Epilepsy was associated with a greater LOS and a higher adjusted incidence rate ratio (IRR) for prolonged LOS (IRR 1.12, 1.09-1.17), particularly for suicide attempt/ideation (IRR 3.74, 1.68-8.34).

Conclusions

Children with epilepsy have distinct patterns of hospital care for mental illness and substance abuse, and experience prolonged hospitalization for MHSA conditions. Strategies to reduce psychiatric hospitalizations in this population may require disease specific approaches and should measure disease relevant outcomes. Hospitals caring for large numbers of children with neurological disease (such as academic centers) may have inaccurate measurements of mental health care quality unless the impact of key comorbid conditions such as epilepsy is considered.


Url:
DOI: 10.1016/j.yebeh.2016.01.031
PubMed: 26963820
PubMed Central: 5347535


Affiliations:

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<p id="P3">We observed 353,319 weighted MHSA hospitalizations of children ages 6 - 20; 3,280 of these involved a child with epilepsy. Depression was the most common MHSA diagnosis in the general population (39.5%) whereas bipolar disorder was the most common MHSA diagnosis among children with epilepsy (36.2%). Multivariate logistic regression models revealed that children with comorbid epilepsy had greater adjusted odds of bipolar disorder (AOR 1.17, 1.04-1.30), psychosis (AOR 1.78, 1.51-2.09), sleep disorder (AOR 5.90, 1.90-18.34), and suicide attempt/ ideation (AOR 3.20, 1.46-6.99) compared to the general MHSA inpatient population. Epilepsy was associated with a greater LOS and a higher adjusted incidence rate ratio (IRR) for prolonged LOS (IRR 1.12, 1.09-1.17), particularly for suicide attempt/ideation (IRR 3.74, 1.68-8.34).</p>
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