Dekker Marielle C, Koot Hans M
Department of Child and Adolescent Psychiatry, Erasmus MC, Rotterdam, The Netherlands.
J Am Acad Child Adolesc Psychiatry. 2003 Aug;42(8):915-22. doi: 10.1097/01.CHI.0000046892.27264.1A.
To assess the prevalence, comorbidity, and impact of DSM-IV disorders in 7- to 20-year-olds with intellectual disability.
A total of 474 children (response 86.8%) were randomly selected from a sample of students from Dutch schools for the intellectually disabled. Parents completed the anxiety, mood, and disruptive disorder modules of the Diagnostic Interview Schedule for Children.
A total of 21.9% of the children met the DSM-IV symptom criteria for anxiety disorder, 4.4% for mood disorder, and 25.1% for disruptive disorder. Similar prevalence rates were found for children who screened positive or negative for pervasive developmental disorder. More than half of the children meeting the criteria for a DSM-IV disorder were severely impaired in everyday functioning, and about 37% had a comorbid disorder. Children with multiple disorders were more likely to be impaired across various areas of everyday functioning. Almost 27% of the diagnosed children received mental health care in the last year. Comorbidity and impairment in everyday functioning increased the likelihood of referral.
Most disorders can be observed in intellectually disabled children. Impairment and comorbidity are high. The finding that less than one third of the children with a psychiatric disorder receive mental health care deserves attention.
评估智力残疾的7至20岁儿童中《精神疾病诊断与统计手册》第四版（DSM-IV）所定义疾病的患病率、共病情况及其影响。
从荷兰智障儿童学校的学生样本中随机选取474名儿童（应答率86.8%）。家长完成了儿童诊断访谈量表中的焦虑、情绪和破坏性行为障碍模块。
共有21.9%的儿童符合DSM-IV焦虑症症状标准，4.4%符合情绪障碍标准，25.1%符合破坏性行为障碍标准。广泛性发育障碍筛查呈阳性或阴性的儿童患病率相似。符合DSM-IV疾病标准的儿童中，超过一半在日常功能方面严重受损，约37%患有共病。患有多种疾病的儿童在日常功能的各个方面更易受损。近27%的已诊断儿童在过去一年接受了心理健康护理。共病情况和日常功能受损增加了转诊的可能性。
大多数疾病可在智障儿童中观察到。损伤和共病情况很常见。不到三分之一的患有精神疾病的儿童接受心理健康护理这一发现值得关注。
