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Department of Epidemiology, Harvard School of Public Health, Boston, Mass 02115, USA.
OBJECTIVES: This study was designed to identify factors associated with service use for child psychopathology in three settings: mental health, general health, and school. METHODS: Subjects were 2519 children, 6 to 11 years of age, assessed in two cross-sectional Connecticut surveys in the late 1980s. Three groups of variables (sociodemographics, child's illness profile, and parental attitudes) were examined through multivariate logistic regression. RESULTS: Most sociodemographics showed moderate associations with all settings, although some previously reported effects (e.g. birth order, sibship size) were not observed. Of the illness profile measures, only Child Behavior Checklist total scores predicted use in the final model (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.1, 2.3). Health problems were associated with increased use in all settings (OR = 1.5, 95% CI = 1.3, 1.9), while academic problems were associated only with increased school service use (OR = 5.2, 95% CI = 3.9, 7.0). Parental belief that the child needed help was most strongly associated with service use (common OR for all settings = 5.3, 95% CI = 4.1, 6.8). CONCLUSIONS: Sociodemographics, parental attitudes, and children's illness profiles independently influence service use for psychopathology in school-aged children.
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