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Pediatric Somatic and Psychiatric Hospital Contacts in Denmark: A National Overview of Risk Factors, Admissions, and
Lone Graff Stensballe1,2,3, Andreas Jensen1,2
1Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Insights
Children with pediatric psychiatric conditions face higher mortality and morbidity. This study highlights the critical need for integrated care to address the increased risks associated with comorbid somatic and psychiatric diseases in youth.
Area of Science:
- Pediatric Health
- Psychiatric Comorbidity
- Public Health Research
Background:
- Previous research indicates comorbidity between pediatric somatic and psychiatric diseases, but population-level data on these associations and their impact on mortality and morbidity are scarce.
- Understanding these comorbidities is crucial for developing effective healthcare strategies for children and adolescents.
Purpose of the Study:
- To investigate the associations between pediatric somatic and psychiatric diseases in the Danish population.
- To examine the impact of these comorbidities on mortality and morbidity in children and adolescents.
Main Methods:
- A national cohort study utilizing Danish register data from 2019 to 2023, including 1,413,177 children and adolescents.
- Patients were categorized into somatic-only, psychiatric-only, and somatic-psychiatric groups using a new-user design based on hospital contact history.
- Assessment of background factors, mortality, and hospital contacts across the defined patient groups.
Main Results:
- The somatic-only group was the largest, followed by the somatic-psychiatric and psychiatric-only groups.
- Pediatric patients with both somatic and psychiatric conditions exhibited a higher 3-year readmission risk (12.1%) and longer hospital stays compared to somatic-only patients.
- Psychiatric patients, particularly those with comorbid conditions, experienced significantly higher all-cause mortality and morbidity, with psychiatric contacts often involving severe diagnoses like suicide attempts.
Conclusions:
- Children with psychiatric conditions face substantially higher mortality and morbidity, despite somatic hospital contacts being more frequent.
- Findings underscore the importance of integrated care models, especially given the rise in pediatric psychiatric diagnoses and policy shifts towards integrated care in Denmark.
- Further research is recommended to validate these findings and guide resource allocation for pediatric psychiatric services.
Objectives:
Prior studies have identified comorbidity between pediatric somatic and psychiatric diseases within specific diagnostic groups. However, population-level data on these associations and their impact on mortality and morbidity are limited. This study aimed to examine these associations in the Danish pediatric population.
Methods:
We conducted a national cohort study using Danish register data, including 1,413,177 children and adolescents from 2019 to 2023. We assessed background factors, mortality, and hospital contacts across three patient groups: somatic-only, psychiatric-only, and somatic-psychiatric. A new-user design classified patients as somatic-only or psychiatric-only if they had no hospital contacts in the preceding 12 months. Patients with subsequent contacts for the other condition were reclassified into the somatic-psychiatric group.
Results:
Most individuals were included in the somatic-only group (n = 532,324), with fewer in the psychiatric-only group (n = 21,501) or somatic-psychiatric group (n = 23,108). Psychiatric patients were more often boys and from lower socioeconomic backgrounds. Somatic hospital contacts often involved less severe symptoms. In contrast, psychiatric contacts involved specific diagnoses, including suicide attempts. Pediatric patients with both conditions had a higher 3-year readmission risk (12.1%, 95% CI: 11.6%-12.6%) compared to somatic-only patients (9.4%, 95% CI: 9.3%-9.5%), and longer average hospital stays (6.32 vs. 1.97 h). Psychiatric patients also had significantly higher all-cause mortality.
Conclusion:
Somatic hospital contacts were more common, but children with psychiatric conditions faced significantly higher mortality and morbidity. These findings are relevant amid rising pediatric psychiatric diagnoses and recent Danish policy to integrate psychiatric and somatic care. Further research is needed to replicate these findings and inform optimal resource allocation for pediatric psychiatric care.
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