Psychiatric disorders in youths with IDDM: Rates and risk factors
Psychiatric disorders in youths with IDDM: Rates and risk factors
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DOI：
10.2337/diacare.20.1.36
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发表时间：
1997-01-01
期刊：
影响因子：
16.2
通讯作者：
Bonar, LK
中科院分区：
文献类型：
--
作者：
Kovacs, M;Goldston, D;Bonar, LK
目的 - 确定青少年 IDDM 诊断后精神疾病的患病率、相关特征和危险因素。 研究设计和方法 - 采用纵向、自然主义设计，对 92 名 8 至 13 岁的 IDDM 发病青少年进行诊断后随访。他们通过半结构化访谈进行反复评估，并根据操作标准进行诊断。 结果 - 到 IDDM 第 10 年，平均年龄为 20 岁，估计有 47.6% 的样本出现精神障碍。重度抑郁症、品行障碍和广泛性焦虑症是最常见的，其中重度抑郁症的估计发病率（27.5%）显着高于其他障碍。发病率最高的是患病第一年。最初的母亲精神病理学增加了受试者精神疾病的风险，而母亲抑郁是受试者抑郁的特定危险因素。受试者早期的精神疾病也增加了以后发生精神疾病的风险。 结论 - 该结果与其他研究的结果一致，表明当代 IDDM 年轻人样本中的精神发病率升高。发病率部分反映了青春期重度抑郁症和成年早期广泛性焦虑症的高发病率。监测年轻患者及其母亲的心理状态可能有助于识别有精神疾病风险的糖尿病儿童，并促进预防或治疗工作。在 IDDM 的第一年进行监测可能特别有益。
OBJECTIVE - To determine prevalence rates, associated features, and risk factors for psychiatric disorders subsequent to the diagnosis of IDDM in youths.RESEARCH DESIGN AND METHODS - Using a longitudinal, naturalistic deign, 92 youths from 8 to 13 years old at onset of IDDM were followed from their diagnosis. They were repeatedly assessed by semistructured interview and diagnosed by operational criteria.RESULTS - By the 10th year of IDDM and the mean age of 20 years, an estimated 47.6% of the sample developed psychiatric disorder. Major depressive, conduct, and generalized anxiety disorders were the most prevalent, and major depression had a significantly higher estimated rate (27.5%) than each other disorder. The highest incidence rates were during the 1st year of the medical condition. Initial maternal psychopathology increased the risk of psychiatric disorder in the subjects, and maternal depression was a specific risk factor for depression in the subjects. Earlier psychiatric disorder in the subjects also increased the risk of later disorder.CONCLUSIONS - The results converge with findings from other studies, suggesting elevated psychiatric morbidity in contemporary samples of young people with IDDM. The morbidity partly reflects the high incidence of major depression in adolescence and generalized anxiety disorder in young adulthood. Monitoring the psychological status of young patients and their mothers may help to identify diabetic children at risk for psychiatric disorder and facilitate prevention or treatment efforts. Monitoring may be particularly beneficial during the 1st year of the IDDM.