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[日本学童精神障碍的流行病学调查。第三部分:初中生精神障碍的患病率]

[Epidemiological survey of psychiatric disorders in Japanese school children. Part III: Prevalence of psychiatric disorders in junior high school children].

作者信息

Suzuki M, Morita H, Kamoshita S

机构信息

Department of Public Health, Gunma University of Medicine.

出版信息

Nihon Koshu Eisei Zasshi. 1990 Dec;37(12):991-1000.

PMID:2132376
Abstract

In order to determine the prevalence of psychiatric disorders in junior high school children, an epidemiological survey of Japanese regular public junior high school children was conducted using Rutter's questionnaire method for screening and a diagnostic interview by pediatricians for the final diagnosis. Both teacher's and parent's questionnaires by Rutter were utilized. Two pediatricians carried out semi-structured interviews of 10-12 minutes for every child and diagnosed their mental state. In part 1 (previously reported), the Japanese version of Rutter's questionnaires was found to be satisfactory for screening, and the diagnostic interview used in this survey was shown to be a reliable tool for the diagnosis of psychiatric disorders of the adolescent. In part 2, the prevalence of psychiatric disorders was studied in the 592 school children who were the subject of the preliminary survey. In the present study, a total of 1,992 children from 5 junior high schools in Gunma prefecture were surveyed cross-sectionally of whom 1,672 (84.3%) screened negative, and 312 (15.7%) positive. The positives and a part of the negatives were randomly selected for interviews, and were diagnosed as to whether they have psychiatric disorders or not by the criteria of Rutter. The overall prevalence rate of diagnosed psychiatric disorders in these school children was 14.8%, (20.1% for males and 8.3% for females). The prevalence rate is significantly higher in males than in females. Disorders diagnosed were classified into emotional, conduct, and mixed disorder, based on Rutter's classification. No cases of schizophrenia and anorexia nervosa were found here as well as in the preliminary survey. The ratio of emotional to conduct disorders was 1.9. Prevalence of conduct disorder in females was one seventh that in males. This study also revealed that the questionnaire method is effective for screening for psychiatric disorders in children, but is not sufficient for differentiating types of disorders. Therefore the diagnostic interview was shown to be useful not only for epidemiological surveys but also for mental health services.

摘要

为了确定初中儿童精神障碍的患病率,采用Rutter问卷法进行筛查,并由儿科医生进行诊断性访谈以做出最终诊断,对日本公立初中的儿童进行了一项流行病学调查。同时使用了Rutter的教师问卷和家长问卷。两名儿科医生对每个儿童进行了10 - 12分钟的半结构化访谈,并对他们的精神状态进行诊断。在第1部分(先前已报道)中,发现Rutter问卷的日文版对于筛查是令人满意的,并且本调查中使用的诊断性访谈被证明是诊断青少年精神障碍的可靠工具。在第2部分中,对作为初步调查对象的592名在校儿童的精神障碍患病率进行了研究。在本研究中,对群马县5所初中的1992名儿童进行了横断面调查,其中1672名(84.3%)筛查为阴性,312名(15.7%)为阳性。对阳性和部分阴性儿童随机选取进行访谈,并根据Rutter标准诊断他们是否患有精神障碍。这些在校儿童中确诊精神障碍的总体患病率为14.8%(男性为20.1%,女性为8.3%)。男性患病率显著高于女性。根据Rutter分类,确诊的障碍分为情绪障碍、品行障碍和混合性障碍。在此以及初步调查中均未发现精神分裂症和神经性厌食症病例。情绪障碍与品行障碍的比例为1.9。女性品行障碍的患病率是男性的七分之一。本研究还表明,问卷法对于筛查儿童精神障碍是有效的,但不足以区分障碍类型。因此,诊断性访谈不仅对流行病学调查有用,而且对心理健康服务也有用。

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