The global coverage of prevalence data for mental disorders in children and adolescents
The global coverage of prevalence data for mental disorders in children and adolescents
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DOI：
10.1017/s2045796015001158
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发表时间：
2017-08-01
影响因子：
8.1
通讯作者：
Scott, J. G.
中科院分区：
文献类型：
--
作者：
Erskine, H. E.;Baxter, A. J.;Scott, J. G.
目标。儿童和青少年占世界人口的近四分之一，其中85%生活在低收入和中等收入国家。在全球范围内，精神（和药物使用）障碍是青年人残疾的主要原因;然而，流行率数据的代表性或“覆盖面”尚不清楚。覆盖面是指现有数据所代表的目标人口（5-17岁）的比例。行为障碍（CD）、注意力缺陷/多动障碍（ADHD）、自闭症谱系障碍（ASD）、进食障碍（ED）、抑郁症和焦虑症的患病率数据来源于2010年（GBD 2010）和2013年（GBD 2013）全球疾病负担研究的系统性综述。对于每项研究，地点比例乘以年龄比例，得出研究覆盖率。通过将总研究地点人群除以总研究地点人群计算地点比例。年龄比例的计算方法是将研究样本年龄范围内的国家人口除以研究样本年龄范围内的国家人口。如果一项研究只对一种性别进行抽样，则研究覆盖率减半。然后对每个国家的研究覆盖率进行求和，以提供按国家分列的覆盖率。该方法在区域和全球层面重复，并分别用于GBD 2013和GBD 2010。全球5-17岁精神障碍患病率数据的平均覆盖率为6.7%（CD：5.0%，ADHD：5.5%，ASD：16.1%，ED：4.4%，抑郁：6.2%，焦虑：3.2%）。在187个国家中，124个国家没有任何疾病的数据。许多低收入国家在现有患病率数据中的代表性很差，例如，撒哈拉以南非洲没有一个地区的任何疾病覆盖率超过2%。虽然2010年GBD和2013年GBD之间的覆盖率有所增加，但不同疾病之间的覆盖率差异很大，并且很少有新的国家提供数据。儿童和青少年精神障碍患病率数据的全球覆盖范围有限。必须制定切实可行的方法，并为流行病学调查提供资金，以提供有代表性的流行率估计数，从而为适当的资源分配提供信息，并支持满足儿童和青少年心理健康需求的政策。
Aims. Children and adolescents make up almost a quarter of the world's population with 85% living in low- and middle-income countries (LMICs). Globally, mental (and substance use) disorders are the leading cause of disability in young people; however, the representativeness or 'coverage' of the prevalence data is unknown. Coverage refers to the proportion of the target population (ages 5-17 years) represented by the available data.Methods. Prevalence data for conduct disorder (CD), attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders (ASDs), eating disorders (EDs), depression, and anxiety disorders were sourced from systematic reviews conducted for the Global Burden of Disease Study 2010 (GBD 2010) and 2013 (GBD 2013). For each study, the location proportion was multiplied by the age proportion to give study coverage. Location proportion was calculated by dividing the total study location population by the total study location population. Age proportion was calculated by dividing the population of the country aged within the age range of the study sample by the population of the country aged within the age range of the study sample. If a study only sampled one sex, study coverage was halved. Coverage across studies was then summed for each country to give coverage by country. This method was repeated at the region and global level, and separately for GBD 2013 and GBD 2010.Results. Mean global coverage of prevalence data for mental disorders in ages 5-17 years was 6.7% (CD: 5.0%, ADHD: 5.5%, ASDs: 16.1%, EDs: 4.4%, depression: 6.2%, anxiety: 3.2%). Of 187 countries, 124 had no data for any disorder. Many LMICs were poorly represented in the available prevalence data, for example, no region in sub-Saharan Africa had more than 2% coverage for any disorder. While coverage increased between GBD 2010 and GBD 2013, this differed greatly between disorders and few new countries provided data.Conclusions. The global coverage of prevalence data for mental disorders in children and adolescents is limited. Practical methodology must be developed and epidemiological surveys funded to provide representative prevalence estimates so as to inform appropriate resource allocation and support policies that address mental health needs of children and adolescents.