少年儿童精神疾病患者病前生活事件分析

Analysis of premorbid life events in children and adolescents with mental disorders

目的:探讨少年儿童精神障碍患者病前生活事件。方法:回顾性分析2225例住院治疗的3~18岁精神障碍患儿病前生活事件及其与患者年龄、性别、精神疾病诊断的关系。结果:699例入组者(31.42%)起病过程中存在至少1件生活事件;依次为学习压力类309例、受惩罚类181例、健康适应类142例、丧失类105例、其他69例、人际关系类66例;生活事件阳性率:675例儿童组中为31.70%,1550例少年组中为31.29%,两组间比较差异无统计学意义;1148例女性组中为34.41%,显著高于男性组(28.23%)(χ2=9.85,P<0.01)。其中女性组学习压力类生活事件明显多于男性组(P<0.05);生活事件在精神疾病出现最多的依次为创伤及应激相关障碍(100.00%)、躯体形式障碍及分离性障碍(71.59%)、抑郁障碍(43.09%)、焦虑障碍(41.67%)以及进食障碍(39.02%)。结论:儿童少年精神障碍患者病前生活事件发生率较高;女性患者更易遭遇生活事件影响,以学习压力为甚;创伤及应激相关障碍等均与生活事件相关。

Objective:To explore life events of children and adolescents before having mental disorders.Method:The premorbid life events of 2225 hospitalized children and adolescents with mental disorders were retrospectively analyzed.The relationships of age,sex and different mental disorders with types of life events were explored.Results:699 patients(31.42%)had at least one life event during the course of onset.There were 309 with learning stress,181 with punishment,142 with health adaptation,105 with loss,69 with other life events,and 66 with interpersonal relationship.The positive rate of life events in 675 children and 1550 adolescents were 31.70%and 31.29%,there was no significant difference.The positive rate of life events in 1148 female patients was 34.41%,which was significantly higher than that in male patients(28.23%)(χ2=9.85,P<0.01).The female group was significantly more stressful in learning than the male group(P<0.05).The most common life events in mental disorders were traumatic and stress-related disorders(100.00%),somatic symptom and dissociative disorders(71.59%),depression disorders(43.09%),anxiety disorders(41.67%)and eating disorders(39.02%).Conclusion:The incidence of life events before being ill is higher in children and adolescents with mental disorders.Female patients are more likely to be affected by life events,especially learning stress.Mental disorders such as traumatic and stress-related disorders are associated with life events.