Income-Related Gender Differences in Psychiatric Hospital Admissions Among Children and Adolescents

Abstract Children from low-income households have more mental disorders, although these connections have rarely been studied in terms of mental health service utilization in population-based data. In this national register-based cohort study all persons born and living in Finland with their families from 1991 to 2017 (n = 1 520 415) were followed until first psychiatric hospital admission, moving away from home, death, emigration, disappearance, or the end of 2017. We calculated age-, gender-, and household income-specific incidence rates (IR) and incidence rate ratios (IRR) for first admissions. In total, 27 691 (13 829 [49.9%] girls) persons were admitted for the first time to psychiatric hospital during the research period. In girls in all income deciles, IRs distinctly peaked at the age of 15 (at age 15 IR = 74.15, 95% CI 71.19–77.21). In boys, IRs started to increase after the age of 5, especially in the lowest income deciles, and there was no rapid peak in adolescence in any income group (at age 5 IR = 3.36, 95% CI 2.93–3.84; at age 10 IR = 26.13, 95% CI 24.70-27.62; at age 15 IR = 27.82, 95% 26.06–29.67). Overall, we observed a negative income gradient in first admissions, which was steeper for boys than for girls. These results highlight household income as an important risk factor for psychiatric hospitalizations in childhood and adolescence. Notably, low income appears to play a more prominent role in boys, whereas adolescence emerges as a critical period for girls, regardless of their household income levels.