Predictors of Hospitalization in a Cohort of Children with Elevated Symptoms of Mania

Abstract

Describe hospitalization rates in children with elevated symptoms of mania and determine predictors of psychiatric hospitalizations during the 96 month follow-up. Eligible 6–12.9 year olds and their parents visiting 9 outpatient mental health clinics were invited to be screened with the Parent General Behavior Inventory 10-item Mania Scale. Of 605 children with elevated symptoms of mania eligible for follow-up, 538 (88.9%) had ≥ 1 of 16 possible follow-up interviews and are examined herein. Multivariate Cox regression indicated only four factors predicted hospitalizations: parental mental health problems (HR 1.80; 95% CI 1.21, 2.69); hospitalization prior to study entry (HR 3.03; 95% CI 1.80, 4.43); continuous outpatient mental health service use (HR 3.73; 95% CI 2.40, 5.50); and low parental assessment of how well treatment matched child’s needs (HR 3.97; 95% CI 2.50, 6.31). Parental perspectives on mental health services should be gathered routinely, as they can signal treatment failures.

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Funding

This research was supported by the National Institutes of Mental Health (NIMH; R01 MH073967, R01 MH073953, R01 MH073801, and R01 MH073816). The authors thank the NIMH for the support but acknowledge that the findings and conclusions are those of the authors and do not necessarily reflect the opinions of NIMH.

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Correspondence to Sarah McCue Horwitz.

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Conflict of interest

Authors Horwitz, Hoagwood, Guo, and Taylor declare that they have no conlict of interest. Dr. Arnold has received research funding from Curemark, Forest, Lilly, Neuropharm, Novartis, Noven, Shire, Supernus, Roche, and YoungLiving (as well as NIH and Autism Speaks), has consulted with Gowlings, Neuropharm, Organon, Pfizer, Sigma Tau, Shire, Tris Pharma, and Waypoint, and been on advisory boards for Arbor, Ironshore, Novartis, Noven, Otsuka, Pfizer, Roche, Seaside Therapeutics, Sigma Tau, Shire. Dr. Young has received research funding from Supernus Pharmaceuticals, Psychnostics, LLC, and the Braing and Behavior Research Foundation. Dr. Youngstrom has consulted with Pearson, Janssen, Lundbeck, Joe Startup Technologies, and Western Psychological Services about psychological assessment. Dr. Fristad receives royalties from American Psychiatric Press, Guilford Press, and Child and Family Psychological Services, Inc. She has research funding from Janssen. Dr. Birmaher receives royalties from Random House, UpToDate, and Lippincott, Williams and Wilkins. Dr. Findling receives or has received research support, acted as a consultant and/or served on a speaker's bureau for Aevi, Akili, Alcobra, Allergan, Amerex, American Academy of Child and Adolescent Psychiatry, American Psychiatric Press, Arbor, Bracket, Daiichi-Sankyo, Epharma Solutions, Forest, Genentech, Insys, Ironshore, KemPharm, Lundbeck, Merck, NIH, Neurim, Noven, Nuvelution, Otsuka, PCORI, Pfizer, Physicians Postgraduate Press, Roche, Sage, Shire, Sunovion, Supernus Pharmaceuticals, Syneurx, Teva, TouchPoint, Tris, and Validus.

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Horwitz, S.M., Hoagwood, K.E., Guo, F. et al. Predictors of Hospitalization in a Cohort of Children with Elevated Symptoms of Mania. Adm Policy Ment Health (2020). https://doi.org/10.1007/s10488-020-01059-6

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Keywords

  • Youth psychiatric hospitalizations
  • Treatment match