Neurodevelopmental disorders: prevalence and comorbidity in children referred to mental health services
Neurodevelopmental disorders: prevalence and comorbidity in children referred to mental health services
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DOI：
10.1080/08039488.2018.1444087
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发表时间：
2018-01-01
影响因子：
1.8
通讯作者：
Kristensen, Hanne
中科院分区：
文献类型：
--
作者：
Hansen, Berit Hjelde;Oerbeck, Beate;Kristensen, Hanne
背景资料：儿童和青少年精神卫生服务（CAMHS）中神经发育障碍（ND）和共病状况的准确患病率对于治疗计划和卫生保健组织至关重要。然而，北欧CAMHS人群的有效和可靠的患病率估计是稀缺的，发表的研究结果各不相同。（注意力缺陷多动障碍：注意力缺陷多动障碍、抽动障碍：TD或自闭症谱系障碍：ASD）和共病障碍，通过经验证的诊断工具对转诊至CAMHS门诊的儿童进行诊断。方法：采用情感性精神障碍和精神分裂症的半结构访谈表，对407名连续转诊的7- 13岁儿童的父母进行了访谈，包括现在版和终生版结果：226名儿童被诊断为一种或多种ND（55.5%; 69.9%男孩）：ADHD（44.5%; 68.5%男孩）; TD（17.7%; 77.8%男孩）和ASD（6.1%; 76%男孩）。在ND儿童中，70例（31.0%）只有一个ND，没有共病障碍，49例（21.7%）有一个以上的ND（同型共病）和131例（58%）有一个非ND精神障碍（异型共病）。焦虑障碍是所有三种ND中最常见的异型共病。共病抑郁障碍与年龄较大，共病焦虑障碍与女性gender.Conclusion：在儿童提到CAMHS，ND构成最常见的一组疾病，高利率的同型和异型共病。在卫生服务规划和提供治疗时需要考虑到这一点。
Background: Accurate prevalence rates of the neurodevelopmental disorders (ND) and comorbid conditions in child and adolescent mental health services (CAMHS) are essential for treatment planning and organization of health care. However, valid and reliable prevalence estimates from Nordic CAMHS populations are scarce, and the published findings vary.Aims: To report prevalence rates of ND (attention-deficit hyperactivity disorder: ADHD, tic disorder: TD or autism spectrum disorder: ASD) and comorbid disorders by a validated diagnostic instrument in children referred to CAMHS outpatient clinics.Methods: Parents of 407 consecutively referred children aged 7-13years were interviewed with the semistructured interview schedule for affective disorders and schizophrenia, present and lifetime version (Kiddie-SADS-PL) at time of admittance.Results: One or more ND was diagnosed in 226 children (55.5%; 69.9% boys): ADHD (44.5%; 68.5% boys); TD (17.7%; 77.8% boys) and ASD (6.1%; 76% boys). Among children with ND 70 (31.0%) had only one ND with no comorbid disorder, 49 (21.7%) had more than one ND (homotypic comorbidity) and 131 (58%) had a non-ND psychiatric disorder (heterotypic comorbidity). Anxiety disorders were the most frequently occurring heterotypic comorbidity in all three ND. Comorbid depressive disorder was associated with older age, and comorbid anxiety disorder with female gender.Conclusion: In children referred to CAMHS, ND constitute the most frequently occurring group of disorders, with high rates of both homotypic and heterotypic comorbidity. This needs to be taken into consideration in health service planning and treatment delivery.