WÖLFLE, S., Jost, D., Oades, R., Schlack,R., Hölling,H., Hebebrand, J.,

Somatic and mental health service use of children and adolescents in Germany (KiGGS-study). 2014 European Child and Adolescent Psychiatry, 23, 753-764. (request a copy)

Introduction: Only a limited number of national surveys have investigated both somatic and mental health service use in children and adolescents.

Method: 1/ The current study aimed to assess service use in Germany as based on at least a single contact with a somatic (pediatrician, general practitioner, nonmedical practitioner) and/or mental health (psychiatrist, psychologist, youth welfare) care specialist within the last 12 months.

2/ Questionnaire responses of 6,475 children and adolescents aged 11.0-17.9 years and their parents were analyzed based on data ascertained by the German Child and Adolescent Health Survey (KiGGS) conducted between 2003 and 2006. For assessment of mental symptom loading the Strengths and Difficulties Questionnaire (SDQ) was completed by parents, thus allowing the determination of the relationship between symptom loading and service use.

3/ ANOVA and logistic regression were performed to determine help-seeking behavior overall and of different health professional groups upon inclusion of the SDQ Total Difficulties score, gender, age and socio-economic status (SES).


1/ A total of 81.9 % of all children and adolescents had used any kind of service within the past 12 months.

2/ 77% percent and 0.8 % used only the somatic and mental health services, respectively; 4.1 % had frequented both services.

3/ Amongst youths with a 'borderline' and 'abnormal' Total Difficulties score, 11.8 and 18.6 %, respectively, sought help from mental health partners.

4/ Age, SES and Total Difficulties score were predictors of any service use; the logistic regression model explained 7.6 % of the variance


a) Use of mental health service was significantly predicted by only age and Total Difficulties score, the respective model explained 26.2 % of the variance.

b) The comparison of health services use on an international level is rendered difficult by national differences in health-care provision. Nevertheless, several of our findings are similar to results obtained in other nationally representative surveys.