The Economic Impact of Subthreshold and Clinical Childhoo Mental Disorders: Supplemental Material

Supplemental online material for the Journal of Mental Health article "The Economic Impact of Subthreshold and Clinical Childhood Mental Disorders". <br> Background: Mental disorders are common health problems associated with serious impairment and economic impact. Aims: To estimate the costs of clinical and subthreshold mental disorders in a sample of Brazilian children. Method: The High Risk Cohort Study is a community study conducted in two major Brazilian cities. Subjects were 6-14 years old children being registered at school. From an initial pool of 9,937 children, two subgroups were further investigated using a random-selection (n=958) and high-risk group selection procedure (n=1,554), resulting in a sample of 2,512 subjects. Mental disorder assessment was made using the Development and Well-Being Assessment. Costs for each child were estimated from the following components: mental health and social services use, school problems and parental loss of productivity. Results: Child subthreshold and clinical mental disorders showed lifetime mean total cost of $1,750.9 and $3,141.2, respectively. National lifetime cost estimate was $10.8 billion for subthreshold mental disorders and $12.8 billion for clinical mental disorders (values in US$ purchasing power parity). Conclusions: This study provides evidence that child mental disorders have a great economic impact on society. There is an urgent need to plan an effective system of care with cost-effective programs of treatment and prevention to reduce economic burden.

《精神卫生杂志（Journal of Mental Health）》刊发的论文《亚阈值与临床型儿童精神障碍的经济影响》配套在线补充材料

背景：精神障碍是一类高发健康问题，与严重功能缺损及显著经济负担密切相关。
研究目标：本研究旨在评估巴西儿童群体中临床型与亚阈值精神障碍的相关经济成本。
研究方法：本研究采用高危队列研究（High Risk Cohort Study）设计，于巴西两座核心城市开展社区流行病学调查。研究对象为6~14岁的在校注册儿童。从初始招募的9937名儿童中，通过随机抽样（n=958）与高危群体筛选（n=1554）两种抽样方式，最终纳入2512名研究对象组成最终样本。精神障碍评估采用发育与福祉评估量表（Development and Well-Being Assessment）完成。每名儿童的相关经济成本从以下维度测算：精神卫生与社会服务使用成本、学业问题相关成本，以及家长因照护产生的生产力损失成本。
研究结果：儿童亚阈值精神障碍与临床型精神障碍的终身平均总成本分别为1750.9美元与3141.2美元。按美元购买力平价（purchasing power parity）计算，亚阈值精神障碍的全国终身总成本估算为108亿美元，临床型精神障碍则为128亿美元。
研究结论：本研究证实儿童精神障碍会对社会造成显著经济负担。当前亟需构建兼具成本效益的治疗与预防项目体系，完善精神卫生照护服务网络，以减轻社会整体经济负担。