[Determinants of the utilization of child psychiatric/psychological treatment and its success]

Factors determining utilization of child psychiatric/psychological treatment facilities by children aged 8 to 13 were investigated as part of a longitudinal epidemiological study. Severity of psychiatric disorder proved to be the variable with the best predictive value. Conduct disorders, along with male sex, low IQ, learning disorders, adverse family circumstances, low social class and the loss of a biological parent were all factors leading to increased utilization of services. In contrast to severity of disorder, however, these variables explain only a relatively small amount of the variance in utilization. A comparison of treated children and a control group matched for age, sex, psychiatric diagnosis and severity of disorder revealed no significant differences in psychiatric status 5 years later. Even when duration and intensity of treatment were considered, there were no significant differences. It was found that although the treated children had experienced about the same number of life events as the control subjects, they perceived them as much more stressful; thus they apparently had less effective coping mechanisms. The results underscore the predictive significance of the psychiatric disorders themselves as well as the fact that nontreatment should not be equated with a negative course of illness or with irresponsible parents or guardians.