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22q11.2缺失综合征儿童及青少年精神疾病诊断与治疗的不一致性

Discordance in Diagnoses and Treatment of Psychiatric Disorders in Children and Adolescents with 22q11.2 Deletion Syndrome.

作者信息

Young Andrea S, Shashi Vandana, Schoch Kelly, Kwapil Thomas, Hooper Stephen R

机构信息

Department of Pediatrics, Division of Medical Genetics, Duke University Medical Center, Durham, NC., USA.

出版信息

Asian J Psychiatr. 2011 Jun 1;4(2):119-124. doi: 10.1016/j.ajp.2011.03.002.

Abstract

This study examines the rate of utilization of mental health services in children and adolescents with 22q11DS relative to their remarkably high rate of psychiatric disorders and behavior problems. Seventy-two children and adolescents with 22q11DS were participants; their parents completed the Diagnostic Interview Schedule for Children (DISC) and the Child Behavior Checklist (CBCL). The results indicated that 22q11DS children and adolescents have higher rates of psychopathology than the general pediatric population, with ADHD and anxiety disorders being the most common. However, among youth with 22q11DS, those with psychopathology are often no more likely to receive either pharmacological or non-pharmacological mental health care than those without a given psychiatric diagnosis. Thus, although psychopathology is fairly common in this sample, many children with 22q11DS may not be receiving needed psychiatric care. These results have significant implications for these children and their families, as well as for the health care providers who treat them. In particular, the results may suggest a need for careful screening of psychiatric disorders that are likely to affect this population as well, as making appropriate treatment recommendations to remedy childhood mental health problems. Since these children face an extraordinarily high risk of psychoses in late adolescence/adulthood, treatment of childhood psychopathology could be crucial in mitigating the risk/consequences of major psychiatric illnesses in later life.

摘要

本研究考察了22q11缺失综合征儿童和青少年的心理健康服务利用率,相较于他们极高的精神疾病和行为问题发生率。72名患有22q11缺失综合征的儿童和青少年参与了研究;他们的父母完成了儿童诊断访谈量表(DISC)和儿童行为检查表(CBCL)。结果表明,22q11缺失综合征儿童和青少年的精神病理学发生率高于普通儿科人群,其中注意力缺陷多动障碍(ADHD)和焦虑症最为常见。然而,在患有22q11缺失综合征的青少年中,有精神病理学问题的人接受药物或非药物心理健康护理的可能性通常并不比没有特定精神疾病诊断的人更高。因此,尽管在这个样本中精神病理学相当普遍,但许多患有22q11缺失综合征的儿童可能没有得到所需的精神科护理。这些结果对这些儿童及其家庭,以及治疗他们的医疗服务提供者具有重大意义。特别是,结果可能表明需要仔细筛查可能也会影响这一人群的精神疾病,并做出适当的治疗建议以解决儿童心理健康问题。由于这些儿童在青春期后期/成年期面临着极高的精神病风险,治疗儿童精神病理学对于减轻后期生活中主要精神疾病的风险/后果可能至关重要。

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