Arcelus Jon, Vostanis Panos
Eating Disorders Service, Brandon Mental Health Unit, Leicester General Hospital, UK.
Curr Opin Psychiatry. 2005 Jul;18(4):429-34. doi: 10.1097/01.yco.0000172063.78649.66.
This review critically discusses recent research findings on psychiatry comorbidity in children and adolescent persons.
Several epidemiological studies have confirmed previous findings in relation to the high rates of psychiatric comorbidity in children and adolescents. In particular, psychiatric comorbidity has been detected in children with substance abuse, and with conduct and oppositional defiant, anxiety and attention deficit-hyperactivity disorders. These studies have also investigated the impact comorbidity has on symptom presentation, outcome and service utilization. Although the presence of concurrent psychiatric disorders in children and adolescents is well established, there has been limited research on the need for different treatment modalities in children suffering from more than one disorder.
It is widely accepted that children and adolescents frequently present with more than one psychiatric diagnosis. The substantial variation in psychiatric comorbidity found in the literature may be due to the different methods of data collection as well as to the classification system used. Whether children and adolescents fulfil diagnostic criteria for a mixed condition (International Classification of Diseases-10) or multiple disorders (Diagnostic and Statistical Manual of Mental Disorders-IV), it is important that the concurrent psychopathology be recognized and treated.
本综述批判性地讨论了儿童和青少年精神疾病共病的近期研究发现。
多项流行病学研究证实了先前关于儿童和青少年精神疾病高共病率的研究结果。特别是，在患有药物滥用、品行障碍和对立违抗障碍、焦虑症以及注意力缺陷多动障碍的儿童中发现了精神疾病共病。这些研究还调查了共病对症状表现、治疗结果和服务利用的影响。尽管儿童和青少年同时存在精神疾病已得到充分证实，但对于患有多种疾病的儿童对不同治疗方式的需求的研究却很有限。
儿童和青少年经常出现不止一种精神疾病诊断，这一点已被广泛接受。文献中发现的精神疾病共病的显著差异可能归因于不同的数据收集方法以及所使用的分类系统。无论儿童和青少年符合混合病症（《国际疾病分类-10》）还是多种疾病（《精神疾病诊断与统计手册-第四版》）的诊断标准，识别并治疗同时存在的精神病理学问题都很重要。
