Adolescents' use of care for behavioral and emotional problems: types, trends, and determinants

Sijmen A Reijneveld; P Auke Wiegersma; Johan Ormel; Frank C Verhulst; Wilma A M Vollebergh; Danielle E M C Jansen

doi:10.1371/journal.pone.0093526

Adolescents' use of care for behavioral and emotional problems: types, trends, and determinants

PLoS One. 2014 Apr 3;9(4):e93526. doi: 10.1371/journal.pone.0093526. eCollection 2014.

Authors

Sijmen A Reijneveld¹, P Auke Wiegersma¹, Johan Ormel², Frank C Verhulst³, Wilma A M Vollebergh⁴, Danielle E M C Jansen¹

Affiliations

¹ University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands.
² University Medical Center Groningen, University of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, the Netherlands.
³ Erasmus Medical Center, Department of Child and Adolescent Psychiatry, Rotterdam, the Netherlands.
⁴ Department of Social Sciences, University of Utrecht, Utrecht, the Netherlands.

Abstract

Objective: While adolescents use various types of care for behavioral and emotional problems, evidence on age trends and determinants per type is scarce. We aimed to assess use of care by adolescents because of behavioral and emotional problems, overall and by type, and its determinants, for ages 10-19 years.

Methods: We obtained longitudinal data on 2,230 adolescents during ages 10-19 from four measurements regarding use of general care and specialized care (youth social care and mental healthcare) in the preceding 6 months, the Child Behavior Checklist (CBCL) and Youth Self-Report, and child and family characteristics. We analyzed data by multilevel logistic regression.

Results: Overall rates of use increased from 20.1% at age 10/11 to 32.2% at age 19: general care was used most. At age 10/11 use was higher among boys, at age 19 among girls. Use of general care increased for both genders, whereas use of specialized care increased among girls but decreased among boys. This differential change was associated with CBCL externalizing and internalizing problems, school problems, family socioeconomic status, and parental divorce. Preceding CBCL problems predicted more use: most for mental health care and least for general care. Moreover, general care was used more frequently by low and medium socioeconomic status families, with odds ratios (95%-confidence intervals): 1.52 (1.23;1.88) and 1.40 (1.17;1.67); youth social care in case of parental divorce, 2.07 (1.36;3.17); and of special education, 2.66 (1.78;3.95); and mental healthcare in case of special education, 2.66 (1.60;4.51).

Discussion: Adolescents with behavioral and emotional problems use general care most frequently. Overall use increases with age. Determinants of use vary per type.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adolescent Behavior / psychology*
Child
Delivery of Health Care / methods
Divorce / psychology
Family Characteristics
Female
Humans
Male
Mental Disorders / psychology*
Mental Disorders / therapy*
Parents / psychology
Self Report
Social Class
Young Adult

Grants and funding

This research is part of the TRacking Adolescents’ Individual Lives Survey (TRAILS). Participating centers of TRAILS include various departments of the University Medical Center and University of Groningen, the Erasmus University Medical Center Rotterdam, the University of Utrecht, the Radboud Medical Center Nijmegen, and the Parnassia Bavo group, all in the Netherlands. TRAILS has been financially supported by the Netherlands Organization for Scientific Research (NWO), ZonMW, GB- MaGW, the Dutch Ministry of Justice, the European Science Foundation, BBMRI-NL, the participating universities, and Accare Center for Child and Adolescent Psychiatry. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.