Calam Rachel, Gregg Lynsey, Goodman Robert
Academic Division of Clinical Psychology, University of Manchester, Second Floor, Education and Research Centre, Wythenshawe Hospital, Manchester M23 9LT, UK.
Psychosom Med. 2005 Jan-Feb;67(1):105-10. doi: 10.1097/01.psy.0000151490.77622.37.
Data from a nationwide child mental health survey were analyzed to examine relationships between asthma and psychological adjustment.
Survey design with random selection based on national computer records of 10,438 children aged 5 to 15 from 12,529 eligible families (83%). Strengths and Difficulties Questionnaire (SDQ) was completed by parents, teachers, and 11- to 17-year-olds, providing scores for total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, social behavior, and total impact. The Development and Well-Being Assessment (DAWBA) generated ICD-10 diagnoses. Parents reported physical disorders and disabilities, other child mental health risk factors, and rated child's general level of health.
Children with organic conditions other than asthma were excluded, leaving 9,834 children, 49.9% male. Preliminary comparisons indicated higher parent and teacher rated scores for children with asthma. New variables combined asthma and general health to produce four groups. Logistic regressions were conducted with children without asthma and in good health as the reference group. Children with asthma in good health showed greater parent-rated emotional problems, but otherwise, few elevated odds ratios. Children without asthma in poor health were at significantly greater risk of disorder, as were children with asthma in poor health. Findings on ratings of hyperactivity are discussed.
Findings that children with asthma have elevated psychological difficulties may result from poor health rather than asthma itself.
分析一项全国性儿童心理健康调查的数据，以研究哮喘与心理调适之间的关系。
采用基于全国计算机记录从12529个符合条件的家庭（83%）中随机选取10438名5至15岁儿童的调查设计。家长、教师以及11至17岁的儿童完成了优势与困难问卷（SDQ），提供了关于总困难、情绪症状、行为问题、多动、同伴问题、社交行为以及总体影响的得分。发育与幸福评估（DAWBA）得出了国际疾病分类第10版（ICD - 10）的诊断结果。家长报告了身体疾病和残疾、其他儿童心理健康风险因素，并对孩子的总体健康水平进行了评分。
排除了患有除哮喘以外的器质性疾病的儿童，剩余9834名儿童，其中49.9%为男性。初步比较表明，哮喘儿童的家长和教师评分较高。新变量将哮喘和总体健康状况相结合，产生了四组。以无哮喘且健康状况良好的儿童作为参照组进行逻辑回归分析。健康状况良好的哮喘儿童表现出家长评定的更多情绪问题，但除此之外，很少有较高的优势比。健康状况不佳的非哮喘儿童以及健康状况不佳的哮喘儿童出现障碍的风险显著更高。文中讨论了关于多动评分的研究结果。
哮喘儿童心理困难加剧的研究结果可能是由于健康状况不佳而非哮喘本身所致。
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