Centre for Disability Research, Lancaster University, Lancaster, LA1 4YT, UK.
Soc Psychiatry Psychiatr Epidemiol. 2010 May;45(5):579-87. doi: 10.1007/s00127-009-0100-y. Epub 2009 Jul 19.
To determine within a nationally representative sample of young Australian children: (1) the association amongst intellectual disability, borderline intellectual functioning and the prevalence of possible mental health problems; (2) the association amongst intellectual disability, borderline intellectual functioning and exposure to social disadvantage; (3) the extent to which any between-group differences in the relative risk of possible mental health problems may be attributable to differences in exposure to disadvantageous social circumstances.
The study included a secondary analysis of a population-based child cohort of 4,337 children, aged 4/5 years, followed up at age 6/7 years. The main outcome measure was the scoring within the 'abnormal' range at age 6/7 years on the parent-completed Strengths and Difficulties Questionnaire.
When compared to typically developing children, children identified at age 4/5 years as having intellectual disability or borderline intellectual functioning: (1) showed significantly higher rates of possible mental health problems for total difficulties and on all five SDQ subscales at age 6/7 years (OR 1.98-5.58); (2) were significantly more likely to be exposed to socio-economic disadvantage at age 4/5 and 6/7 years. Controlling for the possible confounding effects of exposure to socio-economic disadvantage (and child gender) significantly reduced, but did not eliminate, between-group differences in prevalence.
Children with limited intellectual functioning make a disproportionate contribution to overall child psychiatric morbidity. Public health and child and adolescent mental health services need to ensure that services and interventions fit to the purpose and are effective for children with limited intellectual functioning, and especially those living in poverty, as they are for other children.
在澳大利亚全国代表性的年轻儿童样本中确定：（1）智力障碍、边缘智力功能与可能心理健康问题的患病率之间的关联；（2）智力障碍、边缘智力功能与社会劣势暴露之间的关联；（3）智力障碍和边缘智力功能组之间任何与可能心理健康问题相关的相对风险差异在多大程度上可归因于不利社会环境暴露的差异。
本研究对一个基于人群的儿童队列进行了二次分析，该队列包括 4337 名 4/5 岁的儿童，在 6/7 岁时进行了随访。主要结局指标为在 6/7 岁时，父母完成的长处与困难问卷中得分处于“异常”范围的儿童。
与典型发育的儿童相比，在 4/5 岁时被诊断为智力障碍或边缘智力功能的儿童：（1）在 6/7 岁时，总困难和 SDQ 所有五个分量表上的可能心理健康问题的发生率明显更高（OR 1.98-5.58）；（2）在 4/5 岁和 6/7 岁时更有可能暴露于社会经济劣势。控制社会经济劣势（和儿童性别）的可能混杂效应后，显著降低了组间差异，但并未消除患病率的差异。
智力有限的儿童对整体儿童精神发病率的贡献不成比例。公共卫生和儿童及青少年心理健康服务机构需要确保服务和干预措施适合于智力有限的儿童，尤其是那些生活贫困的儿童，因为它们也适用于其他儿童。
