Weiland S K, Pless I B, Roghmann K J
Dept of Social Medicine and Epidemiology, Ruhr-University Bochum, Germany.
Pediatrics. 1992 Mar;89(3):445-9.
The prevalence of chronic physical illnesses and their association with mental disorders was assessed using data collected by primary care pediatricians. A chronic illness was diagnosed in 1573 (15.6%) of 10,058 children aged 4 to 16 years, 945 (9.4%) of whom had a "serious" disorder, 535 (5.3%) had a minor disorder (hay fever or dermatitis), and 121 (1.2%) had a speech or language disorder. Behavioral problems were identified more often among patients with "serious" disorders than among those without chronic illnesses (2.4% vs 1.7%), as were emotional problems (5.0% vs 3.1%). Among those with "serious" conditions involving the central nervous system, the prevalence of behavioral (5.2%) and emotional (10.4%) disorders was still higher. Although children with "serious" disorders not involving the central nervous system also showed elevated prevalence rates of behavioral (2.1%) and emotional (4.5%) disturbances, this increase did not reach statistical significance. No association with "minor" chronic disorders was found. The negative impact of these mental health problems on the child was more severe when a chronic illness was also present, but referrals for mental health services did not reflect his association.
利用初级保健儿科医生收集的数据评估了慢性身体疾病的患病率及其与精神障碍的关联。在10058名4至16岁儿童中，有1573名（15.6%）被诊断患有慢性疾病，其中945名（9.4%）患有“严重”疾病，535名（5.3%）患有轻度疾病（花粉热或皮炎），121名（1.2%）患有言语或语言障碍。与无慢性疾病的患者相比，“严重”疾病患者中行为问题（2.4%对1.7%）和情绪问题（5.0%对3.1%）的识别率更高。在患有涉及中枢神经系统的“严重”疾病的患者中，行为障碍（5.2%）和情绪障碍（10.4%）的患病率仍然更高。虽然不涉及中枢神经系统的“严重”疾病患儿的行为障碍（2.1%）和情绪障碍（4.5%）患病率也有所升高，但这种升高未达到统计学显著性。未发现与“轻度”慢性疾病有关联。当同时存在慢性疾病时，这些心理健康问题对儿童的负面影响更为严重，但心理健康服务的转诊并未反映出这种关联。
