Sørensen Merete Juul, Dalsgaard Søren, Thomsen Per Hove
Psychiatric Hospital for Children and Adolescents, Risskov, Denmark.
Nord J Psychiatry. 2006;60(2):126-31. doi: 10.1080/08039480600583878.
With regard to internalizing disorders we wanted to describe: 1) a possible change in diagnoses over time; 2) a possible corresponding change in causes for referral; 3) correspondence of hospital diagnosis with causes for referral. For 70 randomly selected records/year (n=560), referral papers were examined and compared with register-data on all 8-13-year-old children examined in the study period (1995-2002). The hospital-based frequency increased for depressive disorders and obsessive-compulsive disorder (OCD) and decreased for anxiety disorders. A corresponding increase occurred for depressive and OCD symptoms as cause for referral. Agreement between referral causes and subsequent clinical diagnoses was modest. In most cases (68%) referred for internalizing symptoms, a clinical diagnosis within the internalizing spectrum was given. The increase in the diagnoses of depressive disorder and OCD seems partly due to an increase in patients referred for these disorders. Referrers identify internalizing disorders reliably but child psychiatric examination leads to more precise diagnoses.
关于内化性障碍，我们想要描述：1）诊断随时间的可能变化；2）转诊原因的可能相应变化；3）医院诊断与转诊原因的一致性。每年随机选取70份记录（n = 560），对转诊文件进行检查，并与研究期间（1995 - 2002年）所有接受检查的8 - 13岁儿童的登记数据进行比较。基于医院的抑郁症和强迫症（OCD）发病率上升，焦虑症发病率下降。作为转诊原因的抑郁和强迫症症状相应增加。转诊原因与后续临床诊断之间的一致性一般。在大多数因内化性症状转诊的病例（68%）中，给出了内化性谱系内的临床诊断。抑郁症和强迫症诊断的增加似乎部分归因于转诊至这些疾病的患者增多。转诊者能够可靠地识别内化性障碍，但儿童精神科检查能得出更精确的诊断。
