Racial Disparities in Mental Health Disorders in Youth with Chronic Medical Conditions - 22/08/23
, Rachel T. Kimbro, PhD 2, John C. Shabosky, MD 1, Stefan Kostelyna, MD 1, Titilope Fasipe, MD, PhD 3, Natalie Villafranco, MD 4, Katherine E. Cutitta, PhD 1, Keila N. Lopez, MD, MPH 1Abstract |
Objective |
To evaluate the association between race/ethnicity, poverty, and mental health in youth with chronic conditions.
Study design |
A cross-sectional comparative study was performed using the records of a tertiary care center from 2011 to 2015. Inclusion criteria: children aged 4-17 years with ≥1 hospitalization or emergency department visit. Exclusion criteria were those with arrhythmias or treatment with clonidine/benzodiazepines. The primary outcome variable was diagnosis or medication for anxiety, depression, or attention deficit hyperactivity disorder. The primary predictor variable was diagnosis of cystic fibrosis (CF), sickle cell disease (SCD), or congenital heart disease (CHD).
Results |
We identified 112 313 patients, 0.2% with CF, 0.4% with SCD, and 1.0% with CHD. Patients with CF had the highest prevalence (23%) and odds (OR, 4.21; 95% CI, 3.07-5.77) of anxiety or depression, whereas patients with SCD had the lowest prevalence (7%) and odds (OR, 1.54; 95% CI, 1.11-2.14). Those with CHD had a prevalence of up to 17%, with 3-4 times higher odds of anxiety or depression (OR, 3.70; 95% CI, 2.98-4.61). All non-White participants were less likely to be diagnosed or treated for anxiety or depression and attention deficit hyperactivity disorder. Although poverty increased the probability of anxiety or depression in patients with CHD, this finding was not seen in patients with CF or SCD.
Conclusions |
Children with CF, SCD, and CHD are at increased risk of anxiety or depression; however non-White patients are likely being underdiagnosed and undertreated. Increased screening and recognition in minority children are needed to decrease disparities in mental health outcomes.
Le texte complet de cet article est disponible en PDF.Abbreviations : ADHD, CF, CHD, ED, ICD, SCD, SES
Plan
| Financial Disclosure Statement: The authors have no financial relationships relevant to this article to disclose. |
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| Funding Source: The project was supported by grant number K23 HL127164 (principal investigator: KNL) from the National Institutes of Health/National Heart Lung and Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. |
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| TF has served as a consultant for Novartis, Forma Therapeutics, Global Blood Therapeutics, and Emmaus Medical, Inc.; and received grant funding from Pfizer. |
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Article 113411- août 2023 Retour au numéro
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