Kriti D Gandhi1, Magdalena Romanowicz2, Paul E Croarkin2, Prabin Thapa3, Mara Limbeck4, Jinal Desai5, Amanda J M Benarroch2, Julia Shekunov6. 1. Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Children's, National Takoma Theatre, 6833 4th Street NW, Washington, DC 20012, USA. 2. Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. 3. Department of Biomedical Statistics and Informatics, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. 4. Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; University of Minnesota, 105 Peters Hall, 1404 Gortner Avenue, St. Paul, MN 55108, USA. 5. Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; University of North Dakota School of Medicine & Health Sciences, Department of Psychiatry & Behavioral Science, 1919 Elm St N, Fargo, ND 58102-2416, USA. 6. Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: shekunov.julia@mayo.edu.
Abstract
BACKGROUND: Child maltreatment is prevalent in the United States and carries long-term consequences. Parental substance use may have associations with child maltreatment. It is unclear whether co-occurring parental substance use aggravates childhood psychiatric outcomes related to suspected maltreatment. OBJECTIVE: To compare psychiatric and healthcare utilization outcomes in children with suspected abuse reports, with and without documented parental substance use. PARTICIPANTS AND SETTING: Retrospective cohort study (n = 2831) of children with suspected abuse/neglect (SANC) reports filed in the electronic health record between January 1, 2000 and January 1, 2016. Children who had SANC reports referencing parental substance use (n = 458) were compared with those who had SANC reports that did not reference substance use (n = 2346). METHODS: Outcome data included ICD-10 coded medical and psychiatric diagnoses and healthcare utilization. RESULTS: Compared to children who had a SANC report filed without parental substance use, children with parental substance use in a SANC showed significantly lower age-adjusted odds of anxiety disorder, mood disorder and externalizing disorder, and higher odds of a substance use disorder diagnosis. They were also less likely to present to an emergency department visit for any reason in the year prior to the report. CONCLUSIONS: Children with exposure to parental substance use in a household where parental abuse or neglect was suspected had lower odds of adverse psychiatric outcomes as compared to children with suspected report of abuse or neglect unrelated to parental substance use. The present findings highlight the complex interplay of psychosocial factors associated with outcomes of childhood maltreatment.
BACKGROUND: Child maltreatment is prevalent in the United States and carries long-term consequences. Parental substance use may have associations with child maltreatment. It is unclear whether co-occurring parental substance use aggravates childhood psychiatric outcomes related to suspected maltreatment. OBJECTIVE: To compare psychiatric and healthcare utilization outcomes in children with suspected abuse reports, with and without documented parental substance use. PARTICIPANTS AND SETTING: Retrospective cohort study (n = 2831) of children with suspected abuse/neglect (SANC) reports filed in the electronic health record between January 1, 2000 and January 1, 2016. Children who had SANC reports referencing parental substance use (n = 458) were compared with those who had SANC reports that did not reference substance use (n = 2346). METHODS: Outcome data included ICD-10 coded medical and psychiatric diagnoses and healthcare utilization. RESULTS: Compared to children who had a SANC report filed without parental substance use, children with parental substance use in a SANC showed significantly lower age-adjusted odds of anxiety disorder, mood disorder and externalizing disorder, and higher odds of a substance use disorder diagnosis. They were also less likely to present to an emergency department visit for any reason in the year prior to the report. CONCLUSIONS: Children with exposure to parental substance use in a household where parental abuse or neglect was suspected had lower odds of adverse psychiatric outcomes as compared to children with suspected report of abuse or neglect unrelated to parental substance use. The present findings highlight the complex interplay of psychosocial factors associated with outcomes of childhood maltreatment.
Authors: Magdalena Romanowicz; Jennifer L Vande Voort; Julia Shekunov; Tyler S Oesterle; Nuria J Thusius; Teresa A Rummans; Paul E Croarkin; Victor M Karpyak; Brian A Lynch; Kathryn M Schak Journal: Child Adolesc Psychiatry Ment Health Date: 2019-01-12 Impact factor: 3.033