哮喘患儿照料者的精神症状及障碍

Psychiatric symptomatology and disorders in caregivers of children with asthma.

作者信息

Brown E Sherwood, Gan Vanthaya, Jeffress Jala, Mullen-Gingrich Kacy, Khan David A, Wood Beatrice L, Miller Bruce D, Gruchalla Rebecca, Rush A John

机构信息

Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8849, USA.

出版信息

Pediatrics. 2006 Dec;118(6):e1715-20. doi: 10.1542/peds.2006-1119.

DOI:10.1542/peds.2006-1119

PMID:17142496

Abstract

OBJECTIVE

The prevalence of asthma and asthma-related mortality has increased in recent years. Data suggest an association between psychiatric symptoms in the caregiver and asthma-related hospitalizations in the child. We examined the prevalence of psychiatric symptoms and disorders and their relationship to asthma-related service utilization in caregivers of children hospitalized for asthma.

PATIENTS AND METHODS

Caregivers (n = 175) were assessed during the child's hospitalization. The number of asthma-related hospitalizations, emergency department visits, and unscheduled clinic visits in the past 12 months was obtained. The Brief Symptom Inventory, an assessment of psychiatric symptoms including somatic, anxiety, and depression subscales, and the Mini International Neuropsychiatric Interview, a structured clinical interview for psychiatric disorders, were administered.

RESULTS

Mean age of the caregivers was 34.2 +/- 7.3 years; 96.0% were women; 15.4% were white, 57.7% were black, and 26.3% were Hispanic. A total of 47.9% had incomes less than 25,000 dollars/year. Caregivers with clinically significant elevations in 2 or more Brief Symptom Inventory subscales reported more asthma-related child hospitalizations in the past 12 months than did caregivers with lower Brief Symptom Inventory scores. Asthma-related hospitalizations correlated with Brief Symptom Inventory total, somatic, anxiety, and depression subscale scores. Caregiver diagnosis of an anxiety disorder (n = 36) was associated with more asthma-related hospitalizations in the child. Children of caregivers with current depression (n = 44) had more unscheduled clinic visits than children of caregivers without depression.

CONCLUSION

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined psychiatric disorders, particularly depressive disorders, were common in caregivers and associated with a greater frequency of asthma-related hospitalizations in the child.

摘要

目的

近年来，哮喘的患病率及与哮喘相关的死亡率均有所上升。数据表明，照顾者的精神症状与儿童哮喘相关住院之间存在关联。我们调查了因哮喘住院儿童的照顾者中精神症状和精神障碍的患病率及其与哮喘相关服务利用情况的关系。

患者与方法

在患儿住院期间对175名照顾者进行评估。获取过去12个月内与哮喘相关的住院次数、急诊就诊次数和非预约门诊就诊次数。采用简明症状量表（评估包括躯体、焦虑和抑郁分量表在内的精神症状）和迷你国际神经精神访谈（一种针对精神障碍的结构化临床访谈）进行评估。

结果

照顾者的平均年龄为34.2±7.3岁；96.0%为女性；15.4%为白人，57.7%为黑人，26.3%为西班牙裔。共有47.9%的照顾者年收入低于25,000美元。在简明症状量表中2个或更多分量表临床显著升高的照顾者在过去12个月中报告的与哮喘相关的儿童住院次数多于简明症状量表得分较低的照顾者。与哮喘相关的住院次数与简明症状量表总分、躯体、焦虑和抑郁分量表得分相关。照顾者被诊断为焦虑障碍（n = 36）与儿童更多的哮喘相关住院次数有关。当前患有抑郁症的照顾者（n = 44）的孩子比没有抑郁症的照顾者的孩子有更多的非预约门诊就诊次数。