MENTAL-DISORDERS IN CHRONICALLY ILL CHILDREN - CASE IDENTIFICATION AND PARENT-CHILD DISCREPANCY
MENTAL-DISORDERS IN CHRONICALLY ILL CHILDREN - CASE IDENTIFICATION AND PARENT-CHILD DISCREPANCY
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DOI：
10.1097/00006842-199403000-00005
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发表时间：
1994-03-01
影响因子：
3.3
通讯作者：
CANNING, EH
中科院分区：
文献类型：
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作者：
CANNING, EH
儿童，像成年人和父母一样，依赖初级保健医生来识别，治疗或转介那些患有精神障碍的人。心理健康问题也与儿科护理中越来越多的慢性病儿童密切相关。本文件的重点是：1）儿童和父母之间关于精神障碍的存在以及报案人对病例识别的影响的一致程度; 2）儿科医生在多大程度上同意慢性病儿童和/或其父母关于此类问题的报告。研究样本包括112名9至18岁的儿童，患有癌症，囊性纤维化，炎症性肠病和胰岛素依赖型糖尿病，对照组为35名健康受试者。受试者和父母分别进行了采访，使用高度标准化的，结构化的采访，产生DSM-III-R诊断的计算机算法。儿科医生完成了一份问卷，询问是否存在任何精神障碍。父母和孩子之间的协议是穷人的两组。在医学疾病组，更多的情况下，确定了由家长采访比单独的儿童采访的所有类型的障碍。相比之下，对照组的儿童比他们的父母更经常报告足以诊断的症状。两组之间的患病率差异仅在父母确定的病例中具有显著性，并且医生更有可能识别儿童确定的疾病。在儿科临床护理和研究中，线人的选择对病例识别和病例识别有明确的影响。
Children, like adults and parents, depend on primary care physicians to identify, treat, or refer those with mental disorders. Mental health concerns are also germane to the growing number of chronically ill children in pediatric care. This paper focuses on: 1) the level of agreement between children and parents about the presence of a mental disorder and the impact of informant on case identification; and 2) the extent to which pediatricians agree with reports by chronically ill children and/or their parents regarding such problems. The study sample includes 112 children, ages 9 to 18, with cancer, cystic fibrosis, inflammatory bowel disease, and insulin-dependent diabetes and a control group of 35 healthy subjects. Subject and a parent were interviewed separately using a highly standardized, structured interview that generates DSM-III-R diagnoses by computer algorithms. Pediatricians completed a questionnaire asking about the presence of any mental disorders. Agreement between parent and child was poor for both groups. In the medically ill group, more cases were identified by the parent interview than by child interview alone for all types of disorders. In contrast, children in the comparison group more often reported symptoms sufficient for a diagnosis than did their parents. The difference in prevalence between the two groups was significant only for the parent-identified cases, and physicians were more likely to recognize child-identified disorders. The choice of informant(s) has clear implications for case identification and case recognition in both clinical care and research in pediatric settings.