The healthcare resource impact of maternal mental illness on children and adolescents: UK retrospective cohort studyCitation formats

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The healthcare resource impact of maternal mental illness on children and adolescents: UK retrospective cohort study. / Hope, Holly; Abel, Kathryn; Osam, Nejla Cemre Su; Pierce, Matthias; Ashcroft, Darren; Munford, Luke; Kontopantelis, Evan; Hughes, Sian.

In: The British Journal of Psychiatry., Vol. 219, No. 3, 21.05.2021, p. 515-522.

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@article{3a6a5beeb15c45a188b74d7b5d6ad60d,
title = "The healthcare resource impact of maternal mental illness on children and adolescents: UK retrospective cohort study",
abstract = "Background The general health of children of parents with mental illness is overlooked. Aims To quantify the difference in healthcare use of children exposed and unexposed to maternal mental illness (MMI). Method This was a retrospective cohort study of children aged 0–17 years, from 1 April 2007 to 31 July 2017, using a primary care register (Clinical Practice Research Datalink) linked to Hospital Episodes Statistics. MMI included non-affective/affective psychosis and mood, anxiety, addiction, eating and personality disorders. Healthcare use included prescriptions, primary care and secondary care contacts; inflation adjusted costs were applied. The rate and cost was calculated and compared for children exposed and unexposed to MMI using negative binomial regression models. The total annual cost to NHS England of children with MMI was estimated. Results The study included 489 255 children: 238 106 (48.7%) girls, 112 741 children (23.0%) exposed to MMI. Compared to unexposed children, exposed children had a higher rate of healthcare use (rate ratio 1.27, 95% CI 1.26–1.28), averaging 2.21 extra contacts per exposed child per year (95% CI 2.14–2.29). Increased healthcare use among exposed children occurred in inpatients (rate ratio 1.37, 95% CI 1.32–1.42), emergency care visits (rate ratio 1.34, 95% CI 1.33–1.36), outpatients (rate ratio 1.30, 95% CI 1.28–1.32), prescriptions (rate ratio 1.28, 95% CI 1.26–1.30) and primary care consultations (rate ratio 1.24, 95% CI 1.23–1.25). This costs NHS England an additional £656 million (95% CI £619–£692 million), annually. Conclusions Children of mentally ill mothers are a health vulnerable group for whom targeted intervention may create benefit for individuals, families, as well as limited NHS resources. ",
keywords = "Depressive disorders, in-patient treatment, out-patient treatment, primary care, psychotic disorders",
author = "Holly Hope and Kathryn Abel and Osam, {Nejla Cemre Su} and Matthias Pierce and Darren Ashcroft and Luke Munford and Evan Kontopantelis and Sian Hughes",
note = "Funding Information: This project has received funding from the European Research Council under the European Union's Horizon 2020 research and innovation programme (grant agreement GA682741), and the National Institute for Health Research (reference 111905). The funders had no role in the design, analysis or reporting of the study. Publisher Copyright: Copyright {\textcopyright} The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.",
year = "2021",
month = may,
day = "21",
doi = "10.1192/bjp.2021.65",
language = "English",
volume = "219",
pages = "515--522",
journal = "British Journal of Psychiatry",
issn = "0007-1250",
publisher = "Royal College of Psychiatrists",
number = "3",

}

RIS

TY - JOUR

T1 - The healthcare resource impact of maternal mental illness on children and adolescents: UK retrospective cohort study

AU - Hope, Holly

AU - Abel, Kathryn

AU - Osam, Nejla Cemre Su

AU - Pierce, Matthias

AU - Ashcroft, Darren

AU - Munford, Luke

AU - Kontopantelis, Evan

AU - Hughes, Sian

N1 - Funding Information: This project has received funding from the European Research Council under the European Union's Horizon 2020 research and innovation programme (grant agreement GA682741), and the National Institute for Health Research (reference 111905). The funders had no role in the design, analysis or reporting of the study. Publisher Copyright: Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.

PY - 2021/5/21

Y1 - 2021/5/21

N2 - Background The general health of children of parents with mental illness is overlooked. Aims To quantify the difference in healthcare use of children exposed and unexposed to maternal mental illness (MMI). Method This was a retrospective cohort study of children aged 0–17 years, from 1 April 2007 to 31 July 2017, using a primary care register (Clinical Practice Research Datalink) linked to Hospital Episodes Statistics. MMI included non-affective/affective psychosis and mood, anxiety, addiction, eating and personality disorders. Healthcare use included prescriptions, primary care and secondary care contacts; inflation adjusted costs were applied. The rate and cost was calculated and compared for children exposed and unexposed to MMI using negative binomial regression models. The total annual cost to NHS England of children with MMI was estimated. Results The study included 489 255 children: 238 106 (48.7%) girls, 112 741 children (23.0%) exposed to MMI. Compared to unexposed children, exposed children had a higher rate of healthcare use (rate ratio 1.27, 95% CI 1.26–1.28), averaging 2.21 extra contacts per exposed child per year (95% CI 2.14–2.29). Increased healthcare use among exposed children occurred in inpatients (rate ratio 1.37, 95% CI 1.32–1.42), emergency care visits (rate ratio 1.34, 95% CI 1.33–1.36), outpatients (rate ratio 1.30, 95% CI 1.28–1.32), prescriptions (rate ratio 1.28, 95% CI 1.26–1.30) and primary care consultations (rate ratio 1.24, 95% CI 1.23–1.25). This costs NHS England an additional £656 million (95% CI £619–£692 million), annually. Conclusions Children of mentally ill mothers are a health vulnerable group for whom targeted intervention may create benefit for individuals, families, as well as limited NHS resources.

AB - Background The general health of children of parents with mental illness is overlooked. Aims To quantify the difference in healthcare use of children exposed and unexposed to maternal mental illness (MMI). Method This was a retrospective cohort study of children aged 0–17 years, from 1 April 2007 to 31 July 2017, using a primary care register (Clinical Practice Research Datalink) linked to Hospital Episodes Statistics. MMI included non-affective/affective psychosis and mood, anxiety, addiction, eating and personality disorders. Healthcare use included prescriptions, primary care and secondary care contacts; inflation adjusted costs were applied. The rate and cost was calculated and compared for children exposed and unexposed to MMI using negative binomial regression models. The total annual cost to NHS England of children with MMI was estimated. Results The study included 489 255 children: 238 106 (48.7%) girls, 112 741 children (23.0%) exposed to MMI. Compared to unexposed children, exposed children had a higher rate of healthcare use (rate ratio 1.27, 95% CI 1.26–1.28), averaging 2.21 extra contacts per exposed child per year (95% CI 2.14–2.29). Increased healthcare use among exposed children occurred in inpatients (rate ratio 1.37, 95% CI 1.32–1.42), emergency care visits (rate ratio 1.34, 95% CI 1.33–1.36), outpatients (rate ratio 1.30, 95% CI 1.28–1.32), prescriptions (rate ratio 1.28, 95% CI 1.26–1.30) and primary care consultations (rate ratio 1.24, 95% CI 1.23–1.25). This costs NHS England an additional £656 million (95% CI £619–£692 million), annually. Conclusions Children of mentally ill mothers are a health vulnerable group for whom targeted intervention may create benefit for individuals, families, as well as limited NHS resources.

KW - Depressive disorders

KW - in-patient treatment

KW - out-patient treatment

KW - primary care

KW - psychotic disorders

U2 - 10.1192/bjp.2021.65

DO - 10.1192/bjp.2021.65

M3 - Article

VL - 219

SP - 515

EP - 522

JO - British Journal of Psychiatry

JF - British Journal of Psychiatry

SN - 0007-1250

IS - 3

ER -