Martha Canfield, Gail Gilchrist, Johnny Downs, Sam Norton
{"title":"药物使用障碍的经常性护理程序和服务的使用：伦敦南部母亲的回顾性关联数据队列研究。","authors":"Martha Canfield, Gail Gilchrist, Johnny Downs, Sam Norton","doi":"10.1111/add.70179","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>In public family law cases ('care proceedings'), many mothers return to proceedings after having a child removed. Substance use disorder (SUD) is a common feature in these cases. We used a linked dataset between SUD treatment services and family court to identify: i) the prevalence and estimated time for returning to care proceedings, ii) the characteristics of mothers who returned, and iii) differences in SUD treatment service use between mothers who returned to care proceedings and those who did not.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>South London and Maudsley NHS Mental Health Trust (SLaM) catchment area, UK.</p><p><strong>Participants: </strong>480 mothers involved in care proceedings with SUD between 2007 and 2019.</p><p><strong>Measurements: </strong>Substance use treatment records were linked to family court records. Kaplan Meier's time-to-event analysis was used to estimate the probability of returning to court and the recurrence rate. Hazard ratios (95% confidence intervals) were estimated to identify factors using Cox proportional regression analysis.</p><p><strong>Findings: </strong>Following the completion of the first care proceeding case, one-quarter of the cohort returned to proceedings (n = 119). Of returning mothers, 58.0% returned with a new baby and 52.0% had not received SUD treatment during the first proceedings. The risk of returning was highest within five years and was positively associated with younger maternal age [adjusted hazard ratio (aHR) 0.26, 95% confidence interval (CI) = 0.11-0.61], multiple children in initial proceedings (aHR 2.07, 95% CI = 1.36-3.18) and not receiving SUD treatment during initial proceedings (aHR 0.42, 95% CI = 0.29-0.61). The number of contact events with SUD treatment was not statistically significantly associated with returning to proceedings.</p><p><strong>Conclusion: </strong>Among mothers receiving treatment for substance use disorder and involved in care proceedings in England, nearly one in four were likely to appear in a subsequent care proceeding case.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3000,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Recurrent care proceedings and use of services for substance use disorder: A retrospective linked data cohort study of mothers in South London.\",\"authors\":\"Martha Canfield, Gail Gilchrist, Johnny Downs, Sam Norton\",\"doi\":\"10.1111/add.70179\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>In public family law cases ('care proceedings'), many mothers return to proceedings after having a child removed. Substance use disorder (SUD) is a common feature in these cases. We used a linked dataset between SUD treatment services and family court to identify: i) the prevalence and estimated time for returning to care proceedings, ii) the characteristics of mothers who returned, and iii) differences in SUD treatment service use between mothers who returned to care proceedings and those who did not.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>South London and Maudsley NHS Mental Health Trust (SLaM) catchment area, UK.</p><p><strong>Participants: </strong>480 mothers involved in care proceedings with SUD between 2007 and 2019.</p><p><strong>Measurements: </strong>Substance use treatment records were linked to family court records. Kaplan Meier's time-to-event analysis was used to estimate the probability of returning to court and the recurrence rate. Hazard ratios (95% confidence intervals) were estimated to identify factors using Cox proportional regression analysis.</p><p><strong>Findings: </strong>Following the completion of the first care proceeding case, one-quarter of the cohort returned to proceedings (n = 119). Of returning mothers, 58.0% returned with a new baby and 52.0% had not received SUD treatment during the first proceedings. The risk of returning was highest within five years and was positively associated with younger maternal age [adjusted hazard ratio (aHR) 0.26, 95% confidence interval (CI) = 0.11-0.61], multiple children in initial proceedings (aHR 2.07, 95% CI = 1.36-3.18) and not receiving SUD treatment during initial proceedings (aHR 0.42, 95% CI = 0.29-0.61). 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引用次数: 0
摘要
背景和目的：在公开的家庭法案件（“照料诉讼”）中，许多母亲在将孩子带走后再次提起诉讼。物质使用障碍（SUD）是这些病例的共同特征。我们使用SUD治疗服务和家庭法院之间的关联数据集来确定：i)返回护理程序的患病率和估计时间，ii)返回的母亲的特征，以及iii)返回护理程序的母亲与未返回护理程序的母亲之间使用SUD治疗服务的差异。设计：回顾性研究。环境：南伦敦和莫兹利NHS心理健康信托（SLaM）集水区，英国。参与者：2007年至2019年期间参与SUD护理程序的480名母亲。测量方法：药物使用治疗记录与家庭法庭记录相关联。Kaplan Meier的事件时间分析法用于估计重返法庭的概率和复发率。使用Cox比例回归分析估计风险比（95%置信区间）以确定因素。结果：在完成第一个护理程序病例后，四分之一的队列返回程序（n = 119）。在返回的母亲中，58.0%带着新生儿返回，52.0%在第一次程序中未接受SUD治疗。复发风险在5年内最高，并与较年轻的母亲年龄呈正相关[调整风险比（aHR） 0.26, 95%可信区间(CI) = 0.11-0.61]，初始程序中的多个孩子（aHR 2.07, 95% CI = 1.36-3.18）以及初始程序中未接受SUD治疗（aHR 0.42, 95% CI = 0.29-0.61）。与SUD治疗的接触事件数量与复诊无统计学意义相关。结论：在英国接受药物使用障碍治疗并参与护理程序的母亲中，近四分之一的母亲可能出现在随后的护理程序中。
Recurrent care proceedings and use of services for substance use disorder: A retrospective linked data cohort study of mothers in South London.
Background and aims: In public family law cases ('care proceedings'), many mothers return to proceedings after having a child removed. Substance use disorder (SUD) is a common feature in these cases. We used a linked dataset between SUD treatment services and family court to identify: i) the prevalence and estimated time for returning to care proceedings, ii) the characteristics of mothers who returned, and iii) differences in SUD treatment service use between mothers who returned to care proceedings and those who did not.
Design: Retrospective study.
Setting: South London and Maudsley NHS Mental Health Trust (SLaM) catchment area, UK.
Participants: 480 mothers involved in care proceedings with SUD between 2007 and 2019.
Measurements: Substance use treatment records were linked to family court records. Kaplan Meier's time-to-event analysis was used to estimate the probability of returning to court and the recurrence rate. Hazard ratios (95% confidence intervals) were estimated to identify factors using Cox proportional regression analysis.
Findings: Following the completion of the first care proceeding case, one-quarter of the cohort returned to proceedings (n = 119). Of returning mothers, 58.0% returned with a new baby and 52.0% had not received SUD treatment during the first proceedings. The risk of returning was highest within five years and was positively associated with younger maternal age [adjusted hazard ratio (aHR) 0.26, 95% confidence interval (CI) = 0.11-0.61], multiple children in initial proceedings (aHR 2.07, 95% CI = 1.36-3.18) and not receiving SUD treatment during initial proceedings (aHR 0.42, 95% CI = 0.29-0.61). The number of contact events with SUD treatment was not statistically significantly associated with returning to proceedings.
Conclusion: Among mothers receiving treatment for substance use disorder and involved in care proceedings in England, nearly one in four were likely to appear in a subsequent care proceeding case.
期刊介绍：
Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines.
Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries.
Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.
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