Department of Clinical Science and Education, Södersjukhuset, Sachs' Children's Hospital, Karolinska Institute, Stockholm, Sweden.
Acta Paediatr. 2009 Dec;98(12):1977-81. doi: 10.1111/j.1651-2227.2009.01499.x. Epub 2009 Oct 8.
To investigate whether severe loss of activities of daily living (ADL) in asylum-seeking children is associated with physical disease or toxic influences and to describe the clinical course during the recovery process.
A total of 29 asylum-seeking children with severe loss of ADL were regularly assessed by physical examinations, laboratory tests and a structured evaluation of their ADL status during rehabilitation.
A total of 12 children had previously recorded suicide attempts and 21 were recorded to have experienced traumatic events in their country of origin. The mean time from turning point to recovery was 6 months. Of the study participants, 22 needed enteral feeding and 18 gained weight during recovery. All children had a pulse rate and systolic blood pressure within the normal range. No sign of intoxication or physical disease was identified in laboratory tests or clinical examinations, with the exception of one case of epilepsy.
Physical disease, pharmacological sedation or anorexia nervosa was not considered to be a probable cause of the loss of ADL in these children. The high rate of psychosocial risk factors and the stressful event of being in an asylum-seeking process call for further investigation of psychosomatic mechanisms.
探讨寻求庇护的儿童日常生活活动（ADL）严重丧失是否与躯体疾病或中毒影响有关，并描述康复过程中的临床病程。
对 29 例 ADL 严重丧失的寻求庇护的儿童进行定期评估，包括体格检查、实验室检查和 ADL 状态的结构化评估。
共有 12 名儿童以前有过自杀未遂记录，21 名儿童在原籍国经历过创伤事件。从转折点到康复的平均时间为 6 个月。研究参与者中，22 名需要肠内喂养，18 名在康复过程中体重增加。所有儿童的脉搏率和收缩压均在正常范围内。除 1 例癫痫外，实验室检查或临床检查均未发现中毒或躯体疾病的迹象。
在这些儿童中，躯体疾病、药物镇静或神经性厌食症被认为不是 ADL 丧失的可能原因。高比例的心理社会危险因素和寻求庇护过程中的紧张事件需要进一步调查身心机制。
