Reigstad Bjørn, Jørgensen Kirsti, Sund Anne Mari, Wichstrøm Lars
Dept. of Child and Adolescent Psychiatry, Nordlandssykehuset, Bodø, Norway.
Soc Psychiatry Psychiatr Epidemiol. 2006 Apr;41(4):323-31. doi: 10.1007/s00127-005-0027-x. Epub 2006 Jan 19.
The study investigates whether adolescents referred to specialty mental health services from local services differ from adolescents who only have received help for psychiatric problems locally. If so, which factors associate strongest with referral?
Adolescents (n = 76) from an adolescent population sample (N = 2,538) who had received help during the last year for mental problems from local services were compared to a clinical sample of adolescents (N = 129) referred to specialty mental health services from such local services. Comparisons were made according to scores on the Youth Self-Report (YSR); depressive symptoms; family functioning; attachment to parents; self-concept; coping styles; response styles; dysfunctional attitudes; negative life events; daily hassles; socio-demographics.
As compared to adolescents receiving help locally, adolescents in specialty mental health care scored higher on YSR internalising syndrome; YSR attention problems; YSR thought problems; suicidality; psychosocial stressors; knowing someone who had attempted suicide; parental divorce; substance use; recent moves; living in lodgings; lost a pal or boy/girlfriend; and lower on attachment to parents. Multivariate logistic regression analysis identified four factors associated with receiving specialty mental health care: low family functioning; moved previous year; knowing someone who had attempted suicide; own suicidality.
Family functioning as reported by the adolescents, and not mental health problems except for suicidality, was found to be the strongest associated with referral to specialty mental health services. Contrary to findings from many other studies, referral was associated with internalising problems, not externalising ones.
本研究调查了从当地服务机构转介至专科心理健康服务机构的青少年与仅在当地获得过精神问题帮助的青少年是否存在差异。如果存在差异，哪些因素与转介的关联最为紧密？
将来自青少年总体样本（N = 2538）且在过去一年中从当地服务机构获得过精神问题帮助的青少年（n = 76）与从这些当地服务机构转介至专科心理健康服务机构的青少年临床样本（N = 129）进行比较。根据青少年自评量表（YSR）得分、抑郁症状、家庭功能、与父母的依恋关系、自我概念、应对方式、反应方式、功能失调性态度、负面生活事件、日常烦恼以及社会人口统计学特征进行比较。
与在当地获得帮助的青少年相比，专科心理健康护理中的青少年在YSR内化综合征、YSR注意力问题、YSR思维问题、自杀倾向、心理社会应激源、认识有自杀未遂经历的人、父母离异、物质使用、近期搬家、居住在寄宿处、失去朋友或男女朋友等方面得分更高，而在与父母的依恋关系方面得分更低。多因素逻辑回归分析确定了与接受专科心理健康护理相关的四个因素：家庭功能低下、前一年搬家、认识有自杀未遂经历的人、自身自杀倾向。
研究发现，青少年报告的家庭功能而非除自杀倾向外的心理健康问题与转介至专科心理健康服务机构的关联最为紧密。与许多其他研究的结果相反，转介与内化问题相关，而非外化问题。
