Smiley Elita, Cooper Sally-Ann, Finlayson Janet, Jackson Alison, Allan Linda, Mantry Dipali, McGrother Catherine, McConnachie Alex, Morrison Jillian
Section of Psychological Medicine, Division of Community Based Sciences, University of Glasgow, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, UK.
Br J Psychiatry. 2007 Oct;191:313-9. doi: 10.1192/bjp.bp.106.031104.
The point prevalence of mental ill-health among adults with intellectual disabilities is 40.9%, but its incidence is unknown.
To determine the incidence and possible predictors of mental ill-health.
Prospective cohort study to measure mental ill-health in adults with mild to profound intellectual disabilities.
Cohort retention was 70% (n=651). The 2-year incidence of mental ill-health was 16.3% (12.6% excluding problem behaviours, and 4.6% for problem behaviours) and the standardised incidence ratio was 1.87 (95% CI1.51-2.28). Factors related to incident mental ill-health have some similarities with those in the general population, but also important differences. Type of accommodation and support, previous mental ill-health, urinary incontinence, not having impaired mobility, more severe intellectual disabilities, adult abuse, parental divorce in childhood and preceding life events predicted incident ill-health; however, deprivation, other childhood abuse or adversity, daytime occupation, and marital and smoking status did not.
This is a first step towards intervention trials, and identifying subpopulations for more proactive measures. Public health strategy and policy that is appropriate for this population should be developed.
成年智力残疾者中精神健康不佳的时点患病率为40.9%,但其发病率未知。
确定精神健康不佳的发病率及可能的预测因素。
前瞻性队列研究,以测量轻度至重度智力残疾成年人的精神健康状况。
队列保留率为70%(n = 651)。精神健康不佳的2年发病率为16.3%(不包括问题行为的为12.6%,问题行为的为4.6%),标准化发病率比为1.87(95%CI 1.51 - 2.28)。与新发精神健康不佳相关的因素与一般人群有一些相似之处,但也有重要差异。居住和支持类型、既往精神健康不佳、尿失禁、行动能力未受损、智力残疾更严重、成人虐待、童年时期父母离异以及先前的生活事件可预测新发健康不佳;然而,贫困、其他童年虐待或逆境、日间职业以及婚姻和吸烟状况则不能。
这是迈向干预试验以及确定需采取更积极措施的亚人群的第一步。应制定适合该人群的公共卫生战略和政策。