Tonge Bruce John, Hughes Georgina Catherine, Pullen Jill Marie, Beaufoy Jeanette, Gold Stanley
Discipline of Psychological Medicine, Centre for Developmental Psychiatry and Psychology, School of Psychology, Psychiatry and Psychological Medicine, Monash University, Melbourne, Victoria, Australia.
Aust N Z J Psychiatry. 2008 Jul;42(7):627-35. doi: 10.1080/00048670802119770.
Adolescents accessing inpatient psychiatric services typically have severe and complex disturbance. The aim of the present study was to provide a comprehensive description of an adolescent inpatient sample by examining their psychiatric diagnosis, symptomatology and functioning and associated parental mental health, family functioning and cultural and socioeconomic factors. Few studies have described all these factors and existing studies have reported varying results.
Participants were 88 adolescents (37 male) aged 12-18 years (mean=15.4 years) consecutively recruited through a small number of case clinicians from a regional metropolitan public inpatient unit over a 5 year period. Adolescents and parents participated in clinical interviews and completed psychometric measures. Case clinicians provided diagnostic information.
In contrast to previous studies, adolescents were from a cross-section of socioeconomic backgrounds. Results showed a high rate of comorbid Axis I diagnoses with depressive disorders the most common principal diagnosis. Two-thirds of adolescents experienced clinical levels of internalizing problems. Clinical levels of thought disturbance and externalizing problems were reported for most adolescents, although adolescents self-reported fewer of these symptoms. Educational and social difficulties were common. A salient result was the high level of family dysfunction reported by multiple informants. Most parents reported minimal personality or psychological disturbance but results contradicted other studies and may reflect response bias. In a preliminary finding, non-English-speaking background and low socioeconomic status were associated with a psychosis-related principal diagnosis.
Findings indicate the multiplicity of issues facing adolescent inpatients including psychiatric symptoms, impaired personal and family functioning and family cultural and background factors. Treatment that focuses on only some of these factors may have limited effectiveness.
接受住院精神科服务的青少年通常存在严重且复杂的精神障碍。本研究的目的是通过检查青少年的精神科诊断、症状学、功能状况以及相关的父母心理健康、家庭功能以及文化和社会经济因素，对青少年住院样本进行全面描述。很少有研究描述了所有这些因素，并且现有研究报告的结果各不相同。
研究对象为88名年龄在12至18岁（平均 = 15.4岁）的青少年（37名男性），他们在5年时间里通过少数病例临床医生从一个地区性大都市公立住院部连续招募而来。青少年及其父母参与了临床访谈并完成了心理测量。病例临床医生提供诊断信息。
与以往研究不同，青少年来自不同社会经济背景。结果显示共病轴I诊断率很高，其中抑郁症是最常见的主要诊断。三分之二的青少年存在临床水平的内化问题。大多数青少年报告有临床水平的思维障碍和外化问题，尽管青少年自我报告的这些症状较少。教育和社交困难很常见。一个显著的结果是多个信息提供者报告的家庭功能障碍程度很高。大多数父母报告人格或心理障碍程度较轻，但结果与其他研究相矛盾，可能反映了应答偏差。在一项初步发现中，非英语背景和低社会经济地位与与精神病相关的主要诊断有关。
研究结果表明青少年住院患者面临的问题具有多样性，包括精神症状、个人和家庭功能受损以及家庭文化和背景因素。仅关注其中一些因素的治疗可能效果有限。
