WHO GETS TREATED - FACTORS ASSOCIATED WITH REFERRAL IN CHILDREN WITH PSYCHIATRIC-DISORDERS
WHO GETS TREATED - FACTORS ASSOCIATED WITH REFERRAL IN CHILDREN WITH PSYCHIATRIC-DISORDERS
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DOI：
10.1111/j.1600-0447.1990.tb05492.x
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发表时间：
1990-06-01
影响因子：
6.7
通讯作者：
JANISZEWSKI, S
中科院分区：
文献类型：
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作者：
COSTELLO, EJ;JANISZEWSKI, S
一些工业化国家提供的证据表明，只有一小部分患有精神疾病的儿童得到专门治疗。然而，目前尚不清楚为什么一些精神错乱的儿童被带去接受治疗，而另一些儿童则没有。为了在一个社区研究这一问题，使用儿童行为检查表（CBCL）对7至11岁的儿童进行了行为问题筛查; 89名接受治疗的儿童和126名未接受治疗的儿童，所有这些儿童的CBCL评分均在临床范围内（高于第90百分位数），比较了精神病理学，环境因素和适应功能的措施。所有的儿童都使用儿童诊断访谈计划进行评估。在接受精神病诊断的比例或患有一种以上精神疾病的比例方面，两组之间没有差异。未接受治疗的精神障碍儿童与接受治疗的儿童一样可能患有注意力缺陷障碍、焦虑和对立障碍，并且在学校表现不佳。接受治疗的儿童有更多的行为障碍和抑郁症病例，并且更有可能是穷人，男性和黑人。教师报告的行为问题是未经治疗的儿童的两倍，这表明成年人对儿童行为的不适可能比儿童在学校表现不好更有力地促进了转介。研究结果表明，许多未接受治疗的儿童可能不比接受治疗的儿童受损程度低，并且除了精神病理学严重程度之外的其他因素可能决定哪些受干扰的儿童接受心理健康服务。
There is evidence from several industrialized countries that only a small proportion of children with psychiatric disorders receive specialist treatment. It is unclear, however, why some disturbed children are brought for treatment while others are not. To examine this issue in one community, children aged 7 through 11 were screened for behavioral problems using the Child Behavior Checklist (CBCL); 89 treated and 126 nontreated children, all of whom scored in the clinical range (above the 90th percentile) on the CBCL, were compared on measures of psychopathology, environmental factors and adaptive functioning. All the children were assessed using the Diagnostic Interview Schedule for Children. There was no difference between the groups in the proportions receiving a psychiatric diagnosis, or the proportions with more than one psychiatric disorder. The nontreated disturbed children were as likely as the treated ones to have attention deficit disorders, anxiety, and oppositional disorders, and to be failing in school. The treated children had more cases of conduct disorder and depressive disorders, and were more likely to be poor, male and black. Teachers reported twice as many behavioral problems in treated as in untreated children, suggesting that adults'' discomfort with children''s behavior may have been a more potent precipitator of referral than the children''s failure to perform well at school. The findings suggest that many nontreated children may be no less impaired than those who receive treatment, and that other factors than severity of psychopathology may dictate which disturbed children receive mental health services.