Rowe Richard, Maughan Barbara, Goodman Robert
MRC Social, Genetic, and Developmental Psychiatry Center, Box P046, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
J Pediatr Psychol. 2004 Mar;29(2):119-30. doi: 10.1093/jpepsy/jsh015.
We set out to examine the relationship between unintentional injury and common child psychiatric disorders, including both internalizing and externalizing diagnoses.
The 1999 British Child and Adolescent Mental Health Survey provided a nationally representative sample of over 10,000 children aged 5-15 years. Measures included assessment of diagnoses of psychiatric disorder from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, unintentional injury, and a range of potentially related psychosocial factors.
Children with psychiatric disorders had higher rates of unintentional injury. After accounting for psychosocial risk factors and comorbid psychopathology, oppositional defiant disorder (ODD) was independently associated with burns and poisoning. Attention deficit hyperactivity disorder (ADHD) was related to fractures, and depression and anxiety also showed independent links to some injury types.
ODD and ADHD, rather than conduct disorder, appear to be the externalizing disorders associated with unintentional injury. We discuss possible models of the relationships between internalizing disorders and unintentional injury.
我们着手研究意外伤害与常见儿童精神障碍之间的关系，包括内化性和外化性诊断。
1999年英国儿童与青少年心理健康调查提供了一个具有全国代表性的样本，涵盖了10000多名5至15岁的儿童。测量指标包括根据《精神疾病诊断与统计手册》第四版对精神障碍的诊断评估、意外伤害以及一系列潜在相关的心理社会因素。
患有精神障碍的儿童意外伤害发生率更高。在考虑心理社会风险因素和共病精神病理学之后，对立违抗障碍（ODD）与烧伤和中毒独立相关。注意力缺陷多动障碍（ADHD）与骨折有关，抑郁和焦虑也与某些伤害类型存在独立关联。
ODD和ADHD，而非品行障碍，似乎是与意外伤害相关的外化性障碍。我们讨论了内化性障碍与意外伤害之间关系的可能模型。
