| Background:With the rapid economic development,people’s health awareness has improved and they have a higher pursuit of health.After the introduction of the "two-child policy",the health of children and adolescents has become the concern of the whole society.Children and adolescents are at a critical stage of physical and mental development and face psychological stress in many aspects,which can easily develop into psychological disorders or diseases with lifelong effects if not taken seriously.It is estimated that more than 30 million children and adolescents in China are suffering from various psychological problems,and how to ensure the psychological healthy growth of children and adolescents has become a common concern.Objective:The epidemiological study was conducted to understand the population distribution,geographical distribution,temporal distribution,and disease types of young patients,and to explore the epidemiological characteristics of the disease.At the same time,we also conducted a questionnaire survey on the health seeking behavior behavior of the guardians of children and adolescents to investigate the factors influencing the delay in consultation.Materials and Methods:A retrospective case survey was conducted to retrieve,collect and analyze the medical records of patients under 15 years of age from 2018 to 2020 to understand the characteristics of pediatric and juvenile patients seen in recent years.A case-control analysis was conducted to investigate the factors influencing the delayed visits of children and adolescents through a questionnaire survey of guardians of patients from January to April 2021.The above analyzed studies were analyzed using statistical methods according to the type of data and the purpose of the study.Results:1.From 2018 to 2020,there were 3,282 patients including 1,946 males(59.3%)and1,336 females(40.7%),with a male-to-female sex ratio of 1.5:1.Female patients were fewer than male patients,but the average annual growth rate was 55.6%,far exceeding that of male patients by 17.1%.Statistically significant differences were found in the distribution of patients by age group(P<0.01),distribution of major disease categories(P<0.01),and major disease types(P<0.01)by gender.2.The minimum age of patients was 1 year and the maximum age was 15 years,with a median of 10 years and a plurality of 15 years(16.4% of the total).As individuals mature,the older the age group,the more of visits,with the adolescent group(13-15 years)being the predominant group of patients,accounting for 39.2%.Different age groups had different disease characteristics and statistically significant differences in the distribution of major disease categories(P<0.01)and major disease types(P<0.01).3.The timing of outpatient visits is regular,concentrated in the second half of the year,with a high season in the third quarter,with a peak month in September,and a low season in the first quarter,with a low month in February.This has become more evident in 2020 due to COVID-19.4.Due to the lack of mental health resources in the eastern part of Guangdong,outpatients have to come across the city or even across the province to seek medical treatment,and information shows that the proportion of outpatients in local city is only 63.1%,while the proportion of outpatients in other cities reaches 36.9%,of which 18.4% and 12.1% are in Chaozhou and Jieyang respectively,and 6.4% are in other cities inside and outside the Guangdong Province.5.The main types of diseases were mild mental disorders,concentrated in the categories of "psychological developmental disorders" and "mood disorders",accounting for 56.7% of the total."Pervasive developmental disorder" and "depression" were the main types of disorders.The rapid growth of depression over the 3 years,with an average annual growth rate of 109.8% over the 3 years,requires focused attention.6.A total of 153 guardians of children were surveyed in the visit behavior study,of which only 34% were timely visits(visit interval ≤3 months)and 66% were delayed visits(visit interval>3 months).Logistic regression analysis showed that delay in child’s visit was associated with guardian’s mental health awareness,family history,and preferred help measures.The lower the disease perception,the higher the risk of delayed visit for the child,which was statistically significant(OR=0.73,95%CI: 0.59-0.90,P < 0.01);relative to a positive family history,a negative family history increased the risk of delayed visit occurrence,with a statistically significant difference(OR=9.55,95%CI: 1.31-69.44,P<0.05).In terms of preferred measures of help,compared to preferred visits to psychiatric hospitals,preferred visits to general hospitals and pediatric hospitals(OR=9.77,95%CI: 1.14-83.72,P<0.05),preferred visits to psychological counseling facilities(OR=11.64,95%CI: 1.22-111.31,P<0.05),no measures of help(OR=27.9,95%CI: 5.29-147.02,P<0.01),and preferred self-rest treatment(OR=18.42,95%CI: 2.53-134.38,P < 0.01)all increased the risk of delayed consultation,with statistically significant differences.Conclusion:1.The distribution of mental disorders among children and adolescents varies by gender and stage of development,and each has its own characteristics;families and schools should pay different attention and focus on the period in which the child is in.2.The consultation behavior of patients under 15 has regularity,which can be used as a reference basis for outpatient resource deployment,personnel training and science promotion,considering the tight medical resources at this stage.3.The number of patients under 15 with mild psychiatric disorders is predominant,and the number of depression patients has been increasing in recent years,which should be given priority attention.4.Delayed visits for children and adolescents are associated with guardians’ mental health awareness,family history,and preferred help measures.The state and society should increase mental health literacy and strengthen mental health institutions to minimize delays in medical visits of children and adolescence. |
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