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Articles   |    
Specialized Service Use for Psychiatric and Neurodevelopmental Disorders by Age 14 in Finland
David Gyllenberg, M.D., Ph.D.; Mika Gissler, Ph.D.; Heli Malm, M.D., Ph.D.; Miia Artama, Ph.D.; Susanna Hinkka-Yli-Salomäki, Ph.Lic.; Alan S. Brown, M.D., M.P.H.; Andre Sourander, M.D., Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201200544
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Dr. Gyllenberg is with the Department of Psychiatry, Columbia University College of Physicians and Surgeons, and the New York State Psychiatric Institute, New York City (e-mail: dpg2113@columbia.edu), where Dr. Brown and Dr. Sourander are affiliated. Dr. Gyllenberg and Dr. Sourander are also with the Department of Child Psychiatry, University of Turku and Turku University Central Hospital, Turku, Finland, where Dr. Gissler, Dr. Malm, Dr. Artama, and Ms. Hinkka-Yli-Salomäki are affiliated. Dr. Brown is also at the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City. Dr. Gissler is also with the National Institute for Health and Welfare, Helsinki, Finland. Dr. Malm is also with the Department of Teratology Information, HUSLAB, Helsinki. Dr. Artama is also with the Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki.

Copyright © 2014 by the American Psychiatric Association


Objective  Most studies on the diagnostic patterns of usage of specialized services for childhood psychiatric and neurodevelopmental disorders have been cross-sectional, and the aim of this study was to provide longitudinal data.

Methods  The Medical Birth Register and the Finnish Hospital Discharge Register were used to study the use of inpatient or public outpatient specialized services for psychiatric and neurodevelopmental disorders between birth and age 14 in 2010 (cumulative incidence) and in year 2010 at age 14 (one-year prevalence) among Finnish children born in 1996 (N=58,538 singleton live births).

Results  The cumulative incidence of specialized service use for any psychiatric or neurodevelopmental disorders between birth and age 14 was 12.9%, and the one-year prevalence in 2010 at 14 years was 4.2%. The cumulative incidence by age 14 was 5.5% for learning and coordination disorders, 2.2% for anxiety disorders, 2.0% for hyperkinetic disorders, 1.7% for conduct disorders, 1.4% for depression, 1.0% for autism spectrum disorders, and .7% for stress and adjustment disorders. Learning and coordination, hyperkinetic, and autism spectrum disorders were more prevalent among boys, were often diagnosed before school age, and had 9%−51% lifetime comorbidity with each other. Depressive, anxiety, and stress and adjustment disorders had similar distributions between the sexes, were often diagnosed in early adolescence, and showed 8%−31% lifetime comorbidity with each other.

Conclusions  Every eighth Finnish child had visited specialized services for psychiatric or neurodevelopmental disorders sometime between birth and age 14. Learning and coordination disorders were diagnosed more than twice as often as anxiety, hyperkinetic, and conduct disorders.

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Figure 1 The cumulative incidence of specialized service use among children between birth (1996) and age 14 (2010), by sex
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Table 1Specialized service use among all Finnish children born in 1996a
Table Footer Note

a Children were documented as singleton births and were age 14 in 2010. The diagnostic groups are ranked for both sexes according to the cumulative incidence until 2010.

Table Footer Note

b ICD-10 codes are provided in parentheses.

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Table 2Lifetime comorbidity among children in specialized services who were born in 1996 and followed up to 2010a
Table Footer Note

a The percentages indicate the proportion of comorbidity of the diagnostic classes.



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