Objective: 

Trauma exposure is widely prevalent, with more than 60% of adolescents having experienced at least 1 traumatic event and a third of those at high risk to develop posttraumatic stress disorder (PTSD). Data are scarce and out of date on the services children and adolescents with PTSD receive, impeding efforts to improve care and outcomes. This study examines health service use for a large and diverse sample of children and adolescents with and without a diagnosis of PTSD.

Method: 

Using a matched case-control study, we gathered information from 4 large health care systems participating in the Mental Health Research Network. Data from each site's electronic medical records on diagnoses, health care encounters, and demographics were analyzed. Nine hundred fifty-five 4- to 18-year-olds with a diagnosis of PTSD were identified and matched on a 1:5 ratio to 4770 controls. We compared cases with controls on frequency of service use in outpatient primary care, medical specialty care, acute care, and mental health care. We also assessed psychotropic medication use.

Results: 

Children and adolescents diagnosed with PTSD used nearly all physical and mental health service categories at a higher rate than controls. However, one-third of children and adolescents did not receive even 1 outpatient mental health visit (36.86%) during the year-long sampling window.

Conclusion: 

Our findings suggest that children and adolescents diagnosed with PTSD may have unmet mental health needs. They are high utilizers of health services overall, but lower utilizers of the sectors that may be most helpful in resolving their symptoms.

中文翻译：

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患有创伤后应激障碍的儿童和青少年的卫生服务利用情况：病例对照研究

客观的： 

创伤暴露现象普遍存在，超过 60% 的青少年至少经历过一次创伤事件，其中三分之一的青少年有患创伤后应激障碍 (PTSD) 的高风险。关于患有创伤后应激障碍的儿童和青少年所接受的服务的数据稀缺且过时，阻碍了改善护理和结果的努力。这项研究调查了大量不同的儿童和青少年样本的卫生服务使用情况，这些样本包括患有或未患有创伤后应激障碍（PTSD）的诊断。

方法： 

通过匹配的病例对照研究，我们从参与心理健康研究网络的 4 个大型医疗保健系统收集了信息。对每个站点的电子病历中的诊断、医疗保健情况和人口统计数据进行了分析。955 名被诊断为 PTSD 的 4 至 18 岁青少年被识别出来，并以 1:5 的比例与 4770 名对照者进行匹配。我们将门诊初级保健、医疗专科护理、急症护理和精神卫生保健服务使用频率的病例与对照进行了比较。我们还评估了精神药物的使用。

结果： 

被诊断患有创伤后应激障碍的儿童和青少年使用几乎所有身心健康服务类别的比率高于对照组。然而，三分之一的儿童和青少年在长达一年的抽样窗口内甚至没有接受过一次心理健康门诊就诊（36.86%）。

结论： 

我们的研究结果表明，被诊断患有创伤后应激障碍的儿童和青少年可能有未得到满足的心理健康需求。总体而言，他们对卫生服务的利用率较高，但对可能最有助于解决其症状的部门的利用率较低。