Die psychische Gesundheit von Kindern, Jugendlichen und jungen Erwachsenen – Teil 1: Häufigkeit, Störungspersistenz, Belastungsfaktoren, Service-Inanspruchnahme und Behandlungsverzögerung mit Konsequenzen

Zusammenfassung

In einer Vielzahl von Geburtskohortenstudien, epidemiologischen Studien und klinischen Beobachtungsstudien wurden psychische Erkrankungen bei Kindern, Jugendlichen und jungen Erwachsenen in Bezug auf Häufigkeit, Ersterkrankungsalter, Belastungsfaktoren, Störungspersistenz, Service-Inanspruchnahme, Behandlungsverzögerung und Krankheitsverlauf untersucht. Eine Vielzahl von Publikationen befasste sich darüber hinaus mit den Konsequenzen psychischer Erkrankungen hinsichtlich der Krankheitslast, der Versorgungsdefizite sowie der Effektivität und Effizienz von „Early Intervention Services“. Die Ergebnisse zeigen, dass die Mehrzahl aller psychischen Erkrankungen bereits in der Kindheit, Jugend und im frühen Erwachsenenalter erstmals auftreten. Es lassen sich dabei kombinierte und dauerhafte Belastungsfaktoren nachweisen, die das Risiko, (früh und chronisch) psychisch zu erkranken, erhöhen. In der Kindheit und Jugend erstmals aufgetretene psychische Störungen persistieren häufig bis in das Erwachsenenalter. Als wesentliche Ursachen hierfür wurden eine niedrigere Inanspruchnahme von Behandlung und eine lange Behandlungsverzögerung mit verschiedenen negativen Konsequenzen sowie eine allgemein unzureichende Behandlungsqualität bei Kontakt zum Hilfesystem identifiziert. Zahlreiche andere Länder haben dementsprechend begonnen, an der Schnittstelle zwischen Kinder- und Jugend- und Erwachsenenpsychiatrie sog. „Early Intervention Services (EIS)“ zu implementieren. Das vorliegende Review Teil 1 befasst sich mit der Häufigkeit psychischer Erkrankungen, dem Ersterkrankungsalter, Belastungsfaktoren, der Störungspersistenz, Service-Inanspruchnahme und Behandlungsverzögerung und den Konsequenzen für Kinder, Jugendliche und junge Erwachsene.

Abstract

Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called “early intervention services” at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences.

Schlüsselwörter

Prävention - psychische Erkrankungen - Jugendliche - junge Erwachsene

Key words

prevention - mental disorders - adolescents - young adults

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