Sutter Pacific Medical Foundation, Greenbrae, CA 94904, USA.
Postgrad Med. 2011 Jan;123(1):160-8. doi: 10.3810/pgm.2011.01.2256.
Children in the United States are exhibiting extremely high levels of attentional and learning disabilities. Although lead has been eliminated from many industrial products, children continue to come into contact with it, such as in toys and cosmetics. Lead exposure occurs most commonly in poor, urban populations, and can exacerbate psychiatric disorders associated with stress. We present 1) an overview of lead exposure; 2) a detailed summary of current research on the molecular synergy of toxicity caused by lead and stress; 3) a review of human studies that appear to correlate with these molecular findings, including understanding nutrition, environmental enrichment, and caregiving as risk modifiers; and 4) a systematic approach for mental health practitioners in managing children presenting with multiple symptoms and risk factors for mental health conditions. In this article, we review some of the clinical and scientific challenges that relate to the assessment and treatment of children presenting for mental health care who may have potential lead exposure.
美国儿童表现出极高的注意力和学习障碍水平。尽管许多工业产品已不再使用铅，但儿童仍会接触到铅，例如在玩具和化妆品中。铅暴露最常见于贫困的城市人口中，并且会加剧与压力相关的精神疾病。我们提出了 1）铅暴露的概述；2）目前关于铅和压力引起的毒性分子协同作用的研究的详细总结；3）对似乎与这些分子发现相关的人类研究的综述，包括理解营养、环境丰富和养育作为风险调节剂；以及 4）心理健康从业者管理表现出多种心理健康症状和危险因素的儿童的系统方法。在本文中，我们回顾了与评估和治疗可能存在潜在铅暴露的寻求心理健康护理的儿童相关的一些临床和科学挑战。
