Hospitalized children with depression and another illness stay longer

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Children with depression who stay in the hospital for other illnesses like pneumonia, appendicitis, or seizure disorders stay longer, pay more, and are at greater risk of death, research reports.

The new study, which appears in the Journal of Affective Disorders, may be the first to look specifically at children diagnosed with depression and another illness, how the care is being provided and coordinated, and the number of children who die while hospitalized.

“Depression is one of the leading causes of morbidity and mortality in the United States, with one in five children reporting episodes of major depression before the age of 18,” says lead author Mayowa Olusunmade, a psychiatry resident at Rutgers New Jersey Medical School.

“While many studies have recognized the impact of mental health conditions, little is known about the impact of depression, specifically, on hospital utilization and cost. Even more, we discovered there is little research on how much it actually costs to implement prevention strategies.”

The children in the study were 6-20 years old, with a disproportionate number older teenagers, with an average age of about 17 years old. This is likely because depression is more difficult to diagnose/detect in younger children, Olusunmade says.

Researchers also found that depressed children have fewer procedures when admitted for non-mental health reasons. This could relate to the fact that providers may attribute health-related symptoms to the depression and therefore are less likely to perform diagnostic procedure they think unnecessary. Further, depressed patients are less willing to undergo procedures, Olusunmade says.

The findings suggest that routine screening, improved mental health programs, early diagnosis, and prompt referral or treatment of depression in hospitalized children could offer benefits and reduce the burden on hospital resources.

“From a practical point of view, health care providers should expect better outcomes if they screen more aggressively for depression, detect depression earlier in their patients, and manage it appropriately in affected children,” Olusunmade says.

Researchers used data from the Kids’ Inpatient Database (KID) for 2012, a nationally representative database of all inpatient admissions in the United States for patients younger than 21. The database used a nationwide sample of all pediatric admissions, using about 670,000 discharges from the database.

Additional coauthors are from Rutgers New Jersey Medical School and Dow Medical College in Karachi, Pakistan.

Source: Rutgers University