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在流行病学研究中,儿童和家长的哪些单项报告汇总后会导致注意力缺陷多动障碍和对立违抗障碍的诊断。

What single reports from children and parents aggregate to attention deficit-hyperactivity disorder and oppositional defiant disorder diagnoses in epidemiological studies.

作者信息

Granero Rosario, Ezpeleta Lourdes, Domenech José María, de la Osa Nuria

机构信息

Unitat d'Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Bellaterra, Spain.

出版信息

Eur Child Adolesc Psychiatry. 2008 Sep;17(6):352-64. doi: 10.1007/s00787-008-0677-9. Epub 2008 Apr 21.

Abstract

OBJECTIVE

To analyze information on attention deficit-hyperactivity disorder (ADHD)-oppositional defiant disorder (ODD) and its consequences, provided separately or in combination by children and their parents in a longitudinal prospective study of 9-15 year-old children from the general population.

METHOD

Cross-sectional and longitudinal epidemiological indexes were compared for single and multiple reports. We evaluated which informant is required for the identification of each DSM-IV criterion. Logistic regressions determined which features were related with the reporting of the "absence" of symptoms.

RESULTS

Both informants were required in order to obtain complete psychopathological profiles. Single reports provide infra-estimated prevalences (between 8.8 and 22.9% of ADHD and between 1.7 and 7.6% of ODD), risks (around 3% for ADHD and 2% for ODD) and comorbidities. Psychological and functional measures analyzed in the study were relatively similar for cases presenting ADHD/ODD diagnosis, regardless of the diagnostic algorithm (based on single or combined reports); however, these clinical profiles were different to those obtained for non-diagnosed children. The main predictors of not reporting the presence of psychopathology were: large families (OR between 2 and 2.5), children that are conflictive at school (OR ranging between 1.3 and 4.3) or those with poor mental health (OR between 1.1 and 1.6).

CONCLUSIONS

These results may provide guidance for obtaining accurate diagnostic information, properly identifying children with mental health needs and planning the required preventive and corrective measures.

摘要

目的

在一项针对9至15岁普通儿童的纵向前瞻性研究中,分析由儿童及其父母分别或联合提供的关于注意力缺陷多动障碍(ADHD)-对立违抗性障碍(ODD)及其后果的信息。

方法

比较单一报告和多份报告的横断面和纵向流行病学指标。我们评估了识别每项《精神疾病诊断与统计手册》第四版(DSM-IV)标准需要哪些报告人。逻辑回归分析确定了哪些特征与症状“不存在”的报告相关。

结果

为了获得完整的精神病理学概况,需要两位报告人。单一报告提供的患病率估计偏低(ADHD为8.8%至22.9%,ODD为1.7%至7.6%)、风险(ADHD约为3%,ODD约为2%)和共病情况。无论诊断算法如何(基于单一报告或联合报告),研究中分析的心理和功能测量指标在ADHD/ODD诊断病例中相对相似;然而,这些临床概况与未诊断儿童的情况不同。未报告精神病理学存在的主要预测因素包括:大家庭(比值比在2至2.5之间)、在学校有冲突行为的儿童(比值比在1.3至4.3之间)或心理健康状况较差的儿童(比值比在1.1至1.6之间)。

结论

这些结果可为获取准确的诊断信息、正确识别有心理健康需求的儿童以及规划所需的预防和纠正措施提供指导。

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