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Mental disorders among adults formerly in out-of-home care: a systematic review and meta-analysis of longitudinal studies
European Child & Adolescent Psychiatry ( IF 6.0 ) Pub Date : 2021-06-24 , DOI: 10.1007/s00787-021-01828-0
Süheyla Seker 1 , Cyril Boonmann 1 , Heike Gerger 2, 3 , Lena Jäggi 4 , Delfine d'Huart 1 , Klaus Schmeck 1 , Marc Schmid 1
Affiliation  

While children and adolescents placed in child welfare or juvenile justice out-of-home care show higher prevalence rates of mental disorders compared to the general population, it remains unclear whether this pattern persists into adulthood. A quantitative synthesis of existing studies is lacking. The aim of this meta-analysis was to estimate the prevalence rates for mental disorders among adults with a foster or residential child welfare or juvenile justice care history, comparing them where possible to rates among the general population. PubMed, PsycInfo, EMBASE, and Web of Science were systematically searched for epidemiological studies published up to 28 October 2020. Nineteen studies, totaling 604,257 participants, met our inclusion criteria. Random-effects models were used for prevalence rates and odds ratios (OR) of mental disorders, and study quality was rated. A prevalence rate of 30% [95% CI (23.36, 37.36)] for any mental disorder in adults with a child welfare care history was found (3–17% for specific disorders). A prevalence rate of 45% [95% CI (42.38, 47.38)] for any mental disorder was found in adults with a juvenile justice care history (6–66% for specific disorders). For out-of-home placement history, adult mental disorders were significantly higher than in the general population (OR = 1.33–2.76). Studies differed in terms of methodology and the disorder groups considered, so heterogeneity between effect sizes ranged from low to high. Our findings suggest that the high risk that mental health issues will persist in adults with an out-of-home placement history needs to be taken seriously in the transition from adolescence to adulthood. The care systems involved need to collaborate and to be aware of these risks.



中文翻译:


以前接受户外护理的成年人的精神障碍:纵向研究的系统回顾和荟萃分析



虽然与普通人群相比,接受儿童福利或青少年司法机构外护理的儿童和青少年的精神障碍患病率较高,但目前尚不清楚这种模式是否会持续到成年期。缺乏对现有研究的定量综合。这项荟萃分析的目的是估计有寄养或寄宿儿童福利或少年司法护理历史的成年人的精神障碍患病率,并尽可能将其与一般人群的患病率进行比较。我们系统地检索了 PubMed、PsycInfo、EMBASE 和 Web of Science,查找截至 2020 年 10 月 28 日发表的流行病学研究。有 19 项研究(总计 604,257 名参与者)符合我们的纳入标准。使用随机效应模型计算精神障碍的患病率和比值比 (OR),并对研究质量进行评级。研究发现,有儿童福利护理史的成年人中任何精神障碍的患病率为 30% [95% CI (23.36, 37.36)](特定疾病为 3-17%)。在有少年司法护理史的成年人中,任何精神障碍的患病率为 45% [95% CI (42.38, 47.38)](特定疾病为 6-66%)。对于外出安置史,成人精神障碍明显高于一般人群(OR = 1.33–2.76)。研究在方法论和考虑的疾病组方面有所不同,因此效应大小之间的异质性从低到高不等。我们的研究结果表明,在从青春期到成年的过渡过程中,需要认真对待有外出安置史的成年人持续存在心理健康问题的高风险。所涉及的护理系统需要合作并意识到这些风险。

更新日期:2021-06-25
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