Adolescent Hospitalizations Often Result of Mental Disorder

What role do mental disorders play in the hospitalization of children in the United States each year?

A pretty sizeable one between 10 and 17 years of age, according to a study conducted by Marie McCormick, M.D., chair of maternal and child health at the Harvard University School of Public Health, along with staff from the Agency for Healthcare Research and Quality in Rockville, Md.

The results of their study appear in the January, inaugural issue of Ambulatory Pediatrics. The report is titled “Annual Report on Access to and Utilization of Health Care for Children and Youth in the United States—2000.”

The report is based on data collected from 1996 to 1998. The data of greatest interest to psychiatrists have to do with the principal diagnoses of children in American hospitals in 1997. In 1997 children under age 18 accounted for about 18 percent of hospitalizations in the U.S. or about 6.4 million discharges.

Essentially no children between the ages of birth and 4 years were hospitalized because of mental disorders in that year, according to the report. (The major reason for hospitalization from birth to 1 year of age was complications related to childbirth, which comprised 87.6 percent of cases, and the primary reasons for hospitalization of children ages 1 to 4 years were respiratory conditions and diseases of the digestive system, which comprised 40.9 percent and 11.2 percent, respectively, of cases.)

For hospitalized children ages 5 to 9 years, however, mental disorders entered the picture. Yet they still constituted a very small percentage of total diagnoses—only 4 percent—and that is especially modest in view of the major causes for hospitalization in that age group: respiratory conditions (27.7 percent) and injuries and poisonings (14.5 percent).

But for the 10- to 14-year-olds, mental disorders were a significant cause of hospitalization (14.5 percent), second only to injuries and poisoning (16.9 percent). The mental disorders category was principally made up of affective disorders (depression), which accounted for 6.6 percent of all stays.

For the 15- to 17-year-olds, mental disorders were a noteworthy cause of hospitalization. They constituted 13 percent of all diagnoses, third only to pregnancy and childbirth-related diagnoses (38.2 percent) and to injury and poisoning diagnoses (14.5 percent).

Thus, the researchers concluded from these findings that mental disorders are a major reason that adolescents and teens are hospitalized in the United States. As McCormick and her colleagues point out: “In the 10 to 17 age group, one in seven hospital stays is due to mental disorders.”