Incidence of mental health hospitalizations, treated self-harm, and emergency room visits following new anxiety disorder diagnoses in privately insured US children
- 1 February 2019
- journal article
- research article
- Published by Hindawi Limited in Depression and Anxiety
- Vol. 36 (2), 179-189
- https://doi.org/10.1002/da.22849
Abstract
Background Anxiety disorders are one of the most common mental illnesses in children and associated with high healthcare utilization. We aimed to estimate 2-year cumulative incidence of mental health-related hospitalizations, treated self-harm, and emergency room (ER) visits in children newly diagnosed with anxiety disorders and, for context, in children without anxiety disorders. Methods We identified commercially insured treatment naive children (3-17 years) with a new office-based anxiety disorder diagnosis (ICD-9-CM) from 2005-2014 in the MarketScan claims database. We followed children for up to 2 years after diagnosis for the first of each event: mental health-related hospitalization, inpatient, treated self-harm, and ER visits (any, anxiety-related, injury-related). Children without anxiety diagnoses were included as comparators, matched on age, sex, date, and region. We estimated cumulative incidence of each event using Kaplan-Meier analysis. Results From 2005-2014, we identified 198,450 children with a new anxiety diagnosis. One-year after anxiety diagnosis, 2.0% of children had a mental health-related hospitalization, 0.08% inpatient, treated self-harm, 1.4% anxiety-related ER visit, and 20% any ER visit; incidence was highest in older children with baseline comorbid depression. One-year cumulative incidence of each event was lower in the comparison cohort without anxiety (e.g., mental health-related hospitalizations = 0.5%, treated self-harm = 0.01%, and ER visits = 13%). Conclusions Given the prevalence of anxiety disorders, 2-year incidence estimates translate to a significant number of children experiencing each event. Our findings offer caregivers, providers, and patients information to better understand the burden of anxiety disorders and can help anticipate healthcare utilization and inform efforts to prevent these serious events.Funding Information
- National Institute of Mental Health (F31MH107085)
This publication has 47 references indexed in Scilit:
- Treating Pediatric AnxietyBritish Journal of Psychology, 2018
- Contributions of Children With Multiple Chronic Conditions to Pediatric Hospitalizations in the United States: A Retrospective Cohort AnalysisHospital Pediatrics, 2017
- Spending on Children’s Personal Health Care in the United States, 1996-2013JAMA Pediatrics, 2017
- Outpatient Visits and Medication Prescribing for US Children With Mental Health ConditionsPEDIATRICS, 2015
- Monitoring Suicidal Patients in Primary Care Using Electronic Health RecordsThe Journal of the American Board of Family Medicine, 2015
- Need and Unmet Need for Care Coordination Among Children With Mental Health ConditionsPEDIATRICS, 2014
- Diagnostic and Statistical Manual of Mental DisordersPublished by American Psychiatric Association Publishing ,2013
- Global prevalence of anxiety disorders: a systematic review and meta-regressionPsychological Medicine, 2012
- Incidence and Risk Patterns of Anxiety and Depressive Disorders and Categorization of Generalized Anxiety DisorderArchives of General Psychiatry, 2010
- Practice Parameter for the Assessment and Treatment of Children and Adolescents With Depressive DisordersJournal of the American Academy of Child & Adolescent Psychiatry, 2007