Kovacs M, Goldston D, Obrosky D S, Iyengar S
University of Pittsburgh School of Medicine, Department of Psychiatry, PA.
J Am Acad Child Adolesc Psychiatry. 1992 Nov;31(6):1112-9. doi: 10.1097/00004583-199211000-00020.
School-age children were assessed longitudinally for up to 9 years, after the onset of their insulin-dependent diabetes mellitus (IDDM), to determine the time-dependent risk of the psychiatric diagnosis of noncompliance with medical treatment and to examine protective and risk factors. The cumulative risk for this diagnosis over the 9 years was .45. Noncompliance tended to emerge in middle adolescence and was found to be protracted. Social competence, self-esteem, and aspects of family functioning at IDDM onset and initial psychiatric status did not predict noncompliance. However, noncompliance was associated with having major psychiatric disorder later in the course of IDDM.
对学龄儿童在胰岛素依赖型糖尿病（IDDM）发病后长达9年的时间里进行纵向评估，以确定不遵医嘱进行治疗的精神疾病诊断的时间依赖性风险，并检查保护因素和风险因素。9年期间该诊断的累积风险为0.45。不遵医嘱的情况往往在青春期中期出现，且发现持续时间较长。IDDM发病时的社交能力、自尊以及家庭功能方面和初始精神状态并不能预测不遵医嘱的情况。然而，不遵医嘱与IDDM病程后期出现的重度精神障碍有关。
