Mullick Mohammad Sayadul Islam, Goodman Robert
Dept. of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Soc Psychiatry Psychiatr Epidemiol. 2005 Aug;40(8):663-71. doi: 10.1007/s00127-005-0939-5. Epub 2005 Aug 16.
No previous epidemiological studies of child mental health have been conducted in Bangladesh, partly due to lack of suitable measures.
A Bangla translation of a standardised child psychiatric interview, the Development and Well-Being Assessment (DAWBA), was validated against routine clinical diagnoses on a consecutive series of 100 referrals to a child mental health service. A two-phase study of prevalence was applied to random samples of 5- to 10-year-olds (N=922) drawn from three contrasting areas: a rural area, a moderately prosperous urban area, and an urban slum.
There was substantial agreement between the DAWBA and the independent clinic diagnosis (kappa=0.63-0.94). The estimated prevalence of any ICD-10 diagnosis was 15% (95% CI 11-21%). The rate of obsessive-compulsive disorder was higher than in previous studies. Children from the slum area were significantly more likely to have serious behavioural problems, and marginally more likely to have post-traumatic stress disorder.
A conservative extrapolation is that around 5 million Bangladeshi children and adolescents have psychiatric disorders. In a country with very few child mental health professionals, there is a vast gap between need and provision that must be addressed.
孟加拉国此前尚未开展过儿童心理健康的流行病学研究，部分原因是缺乏合适的测量方法。
对标准化儿童精神病学访谈《发育与幸福评估》（DAWBA）进行孟加拉语翻译，并针对连续转诊至儿童心理健康服务机构的100例病例，与常规临床诊断进行验证。对从三个不同地区抽取的5至10岁儿童随机样本（N = 922）进行了两阶段患病率研究，这三个地区分别是农村地区、中等繁荣的城市地区和城市贫民窟。
DAWBA与独立临床诊断之间存在高度一致性（kappa = 0.63 - 0.94）。任何ICD - 10诊断的估计患病率为15%（95%置信区间11 - 21%）。强迫症的发生率高于以往研究。来自贫民窟地区的儿童出现严重行为问题的可能性显著更高，患创伤后应激障碍的可能性略高。
保守推断，约500万孟加拉国儿童和青少年患有精神疾病。在一个儿童心理健康专业人员极少的国家，需求与服务之间存在巨大差距，必须加以解决。
