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品行障碍与成年精神诊断:美国成年人群中的关联与性别差异。

Conduct disorder and adult psychiatric diagnoses: associations and gender differences in the U.S. adult population.

机构信息

Department of Psychiatry, Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 69, New York, NY 10032, USA.

出版信息

J Psychiatr Res. 2012 Mar;46(3):323-30. doi: 10.1016/j.jpsychires.2011.10.012. Epub 2011 Dec 14.

Abstract

The authors' objective was to examine the presence of Axis I and II psychiatric disorders among adult males and females with a history in childhood and/or adolescence of conduct disorder (CD). Data were derived from a large national sample of the U.S. population. Face-to-face interviews of more than 34,000 adults ages 18 years and older were conducted during 2004-2005 using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. After adjusting for sociodemographic characteristics and psychiatric comorbidity, CD was associated with all Axis I and II disorders, particularly substance use disorders (SUD), bipolar disorder, and histrionic personality disorders. After adjusting for gender differences in the general population, men had significantly greater odds of social anxiety disorder and paranoid personality disorder, whereas women were more likely to have SUD. Furthermore, there was dose-response relationship between number of CD symptoms and risk for most psychiatric disorders. From a clinical standpoint, knowledge of the gender differences in associations of CD with other psychiatric disorders in adulthood may be informative of developmental pathways of the disorder, and of possible gender-specific risk factors. Early recognition and treatment of CD may help prevent the development of adult-onset disorders.

摘要

作者的目的是研究童年和/或青少年时期有品行障碍(CD)病史的成年男女中是否存在轴 I 和 II 类精神障碍。数据来自美国人口的大型全国样本。2004-2005 年期间,使用酒精使用障碍和相关障碍访谈时间表-DSM-IV 版本对 34000 多名 18 岁及以上的成年人进行了面对面访谈。在调整了社会人口统计学特征和精神共病之后,CD 与所有轴 I 和 II 障碍相关,特别是物质使用障碍(SUD)、双相情感障碍和表演型人格障碍。在调整了普通人群中性别差异后,男性患有社交焦虑症和偏执型人格障碍的几率显著更高,而女性更有可能患有 SUD。此外,CD 症状的数量与大多数精神障碍的风险之间存在剂量反应关系。从临床角度来看,了解 CD 与成年后其他精神障碍的关联中的性别差异可能有助于了解该障碍的发展途径,以及可能存在的特定于性别的危险因素。早期识别和治疗 CD 可能有助于预防成年期发病的障碍。

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