Risk of emergency hospital admission in children associated with mental disorders and alcohol misuse in the household: an electronic birth cohort study

Paranjothy, Shantini; Evans, Annette; Bandyopadhyay, Amrita; Fone, David; Schofield, Behnaz; John, Ann; Bellis, Mark A.; Lyons, Ronan A.; Farewell, Daniel; Long, Sara Jayne

Abstract

Background: Mental disorders and alcohol misuse are common in families but their effects on the physical health of children are not known. We investigated the risk of emergency hospital admissions during childhood associated with living with an adult who has a mental health disorder, or who had an alcohol-related hospital admission.

Methods: We did this cohort study in a total population electronic child cohort in Wales, UK, which includes all children who live in Wales or with a mother who is resident in Wales. We used Cox regression to model time to first emergency hospital admission during the first 14 years of life associated with living with an adult who has a mental health disorder, or who had an alcohol-related hospital admission. We adjusted our results for social deprivation and perinatal risk factors.

Findings: We included data for 253 717 children with 1 015 614 child-years of follow-up. Living with an adult with a mental disorder was associated with an increased risk of emergency admission for all causes (adjusted hazard ratio [aHR] 1·17, 95% CI 1·16–1·19), for injuries and external causes (1·14, 1·11–1·18), and childhood victimisation (1·55, 1·44–1·67). Children living with a household member who had an alcohol-related hospital admission had a significantly higher risk of emergency admissions for injuries and external causes (aHR 1·13, 95% CI 1·01–1 ·26) and victimisation (1·39, 1·00–1·94), but not for all-cause emergency admissions (1·01, 0·93–1·09).

Interpretation: The increased risk of emergency admissions in children associated with mental disorders and alcohol misuse in the household supports the need for policy measures to provide support to families that are affected.

Funding: Economic and Social Research Council, Medical Research Council, Alcohol Research UK, Public Health Wales.

• Journal Article Type: Article
• Acceptance Date: Jun 18, 2018
• Online Publication Date: May 15, 2018
• Publication Date: Jun 1, 2018
• Deposit Date: Apr 20, 2020
• Publicly Available Date: Apr 21, 2020
• Journal: Lancet Public Health
• Print ISSN: 2468-2667
• Electronic ISSN: 2468-2667
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 3
• Issue: 6
• Pages: e279-e288
• DOI: https://doi.org/10.1016/s2468-2667%2818%2930069-0
• Public URL: https://uwe-repository.worktribe.com/output/4169789
• Additional Information: This article is maintained by: Elsevier; Article Title: Risk of emergency hospital admission in children associated with mental disorders and alcohol misuse in the household: an electronic birth cohort study; Journal Title: The Lancet Public Health; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/S2468-2667(18)30069-0; CrossRef DOI link to the associated document: https://doi.org/10.1016/S2468-2667(18)30094-X; Content Type: article; Copyright: © 2018 The Author(s). Published by Elsevier Ltd.