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6~17岁患精神疾病儿童躯体疾病和精神性疾病共患情况及保健应用
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作者 Spady D.W. schopflocher d.p. +2 位作者 Svenson L.W. Thompson A.H. 刘莉 《世界核心医学期刊文摘(儿科学分册)》 2005年第7期20-21,共2页
Background: The association of psychiatric disorders (PDs)-with other PDs and medical disorders (MDs) has been insufficiently explored in children and adolescents.Objectives: To estimate medical and psychiatric comorb... Background: The association of psychiatric disorders (PDs)-with other PDs and medical disorders (MDs) has been insufficiently explored in children and adolescents.Objectives: To estimate medical and psychiatric comorbidity present in children with PDs and to determine the medical service usage of children with PDs.Design: We use administrative health care data to describe the health care provided for study children.Psychiatric disorders were classified into the following 3 categories: psychosis, emotion, and behavior.We used logistic regression to assess medical comorbidity for each category.Psychiatric comorbidity was determined using χ2 test analysis.Health care use was determined by comparing the frequency of visits for MDs and PDs between children with PDs and children without PDs.Setting: We studied 406 640 children (50.6%male) between 6 and 17 years old, living in Alberta, Canada, during the fiscal year April 1, 1995, through March 31, 1996.Results: A PD was diagnosed in 32 214 (60.3%male) children.Psychiatric comorbidity was present in 13.6%of the children; comorbidity existed in all 3 psychiatric groups and peaked in postpubertal children.More girls than boys had significant medical comorbidity.Significant odds ratios (ORs)-for girls varied from 1.2 (behavior and sinusitis, bronchitis, and chronic disorders; psychosis, and menstrual problems) to 15.3 (behavior and developmental delay).Among boys, the highest OR was seen with the combination of behavior and developmental delay (OR, 8.3) and psychosis and poisoning (OR, 8.2).With ORs ranging from 4.6 to 15.3, developmental delay consistently had high ORs for both sexes and all 3 types of PDs.Poisoning also had high ORs (3.3-14.1)with all 3 PDs and both sexes.Among girls, disorders associated with pregnancy and the genitourinary system had modest associations (OR, 1.9-2.2, for behavior) to moderate (OR, 2.5-4.0, for emotion).Children with PDs had significantly greater medical service usage than did children without PDs.Girls had greater medical health care usage than boys.Psychiatric service usage was similar for both sexes.Conclusions: Medical and psychiatric comorbidity exist in children with PDs.Girls are more commonly affected.Health care usage is higher in children with PDs. 展开更多
关键词 精神性疾病 精神疾病 躯体疾病 躯体性疾病 躯体症状 疾病类型 治疗者 患病儿童 精神状态异常 就诊次数
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