The DSM-IV rates of child and adolescent disorders in Puerto Rico -: Prevalence, correlates, service use, and the effects of impairment
The DSM-IV rates of child and adolescent disorders in Puerto Rico -: Prevalence, correlates, service use, and the effects of impairment
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DOI：
10.1001/archpsyc.61.1.85
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发表时间：
2004-01-01
影响因子：
--
通讯作者：
Martínez-Taboas, A
中科院分区：
文献类型：
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作者：
Canino, G;Shrout, PE;Martínez-Taboas, A
背景：很少有关于在代表性社区样本中的儿童中使用 DSM-IV 标准的患病率研究的报告。我们提供了波多黎各儿童和青少年人口的患病率数据，并在全岛代表性样本中检查了 DSM-IV 诊断与全球损伤、人口相关性和服务使用的关系。 方法：我们采用多阶段抽样设计对波多黎各 1886 名儿童看护者二人组进行了抽样。儿童年龄为 4 至 17 岁。答复率为90.1%。对儿童及其主要看护者的面对面访谈是由经过培训的外行人员进行的，他们使用西班牙语执行了《儿童诊断访谈计划》第四版 (DISC-IV)。整体损伤是通过使用由家长的访谈者评分的儿童整体评估量表来测量的。服务使用报告是通过儿童和青少年服务评估获得的。结果：虽然 19.8% 的样本在不考虑损伤的情况下符合 DSM-IV 标准，但当考虑针对每个诊断的特定损伤测量时，16.4% 的人群患有 I 或更多 DSM-IV 疾病。当在该定义中添加总体损伤衡量标准时，总体患病率进一步降至 6.9%。最常见的疾病是注意力缺陷/多动障碍（8.0%）和对立违抗障碍（5.5%）。城市儿童的发病率高于农村地区的儿童。年龄较大与重度抑郁症和社交恐惧症的发病率较高有关，而年龄较小则与注意力缺陷/多动症的发病率较高有关。总体发生率和特定 DSM-IWDISC-IV 疾病发生率均与服务使用相关。未经诊断的障碍儿童更有可能使用学校服务，而经过诊断的障碍儿童更有可能使用专业心理健康部门。在同时患有诊断和整体损伤的患者中，只有一半接受了任何来源的服务。结论：由于我们使用 DISC-IV 来应用 DSM-IV 标准，因此该研究得出的患病率与之前调查中发现的患病率大致相当。纳入特定诊断的损伤标准略微降低了发生率。当实施全球减值标准时，比率降低了大约一半。
Background: Few prevalence studies in which DSM-IV criteria were used in children in representative community samples have been reported. We present prevalence data for the child and adolescent population of Puerto Rico and examine the relation of DSM-IV diagnoses to global impairment, demographic correlates, and service use in an island-wide representative sample.Methods: We sampled 1886 child-caretaker dyads in Puerto Rico by using a multistage sampling design. Children were aged 4 to 17 years. Response rate was 90.1%. Face-to-face interviews of children and their primary caretakers were performed by trained laypersons who administered the Diagnostic Interview Schedule for Children, version IV (DISC-IV) in Spanish. Global impairment was measured by using the Children's Global Assessment Scale scored by the interviewer of the parent. Reports of service use were obtained by using the Service Assessment for Children and Adolescents.Results: Although 19.8% of the sample met DSM-IV criteria without considering impairment, 16.4% of the population had I or more of the DSM-IV disorders when a measure of impairment specific to each diagnosis- was considered. The overall prevalence was further reduced to 6.9% when a measure of global impairment was added to that definition. The most prevalent disorders were attention-deficit/hyperactivity disorder (8.0%) and oppositional defiant disorder (5.5%). Children in urban settings had higher rates than those in rural regions. Older age was related to higher rates of major depression and social phobia, and younger age was related to higher rates of attention-deficit/hyperactivity disorder. Both overall rates and rates of specific DSM-IWDISC-IV disorders were related to service use. Children with impairment without diagnosis were more likely to use school services, whereas children with impairment with diagnosis were more likely to use the specialty mental health sector. Of those with both a diagnosis and global impairment, only half received services from any source.Conclusions: Because we used the DISC-IV to apply DSM-IV criteria, the study yielded prevalence rates that are generally comparable with those found in previous surveys. The inclusion of diagnosis-specific impairment criteria reduced rates slightly. When global impairment criteria were imposed, the rates were reduced by approximately half.